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Hospital-acquired Clostridium difficile-associated disease in the intensive care unit

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  • Hospital-acquired Clostridium difficile-associated disease in the intensive care unit

    <table border="0" cellpadding="0" cellspacing="0" width="100%"><tbody><tr valign="bottom"><td align="left">Research article
    </td><td align="right"><!-- <rdf:RDF xmlns:cc="http://web.resource.org/cc/" xmlns:rdf="http://www.w3.org/1999/02/22-rdf-syntax-ns#" xmlns:prism="http://prismstandard.org/namespaces/1.2/basic/" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns="http://purl.org/rss/1.0/"> <cc:Work rdf:about="http://www.biomedcentral.com/1471-2334/7/42"> <cc:license rdf:resource="http://creativecommons.org/licenses/by/2.0/"/> </cc:Work> <cc:License rdf:about="http://creativecommons.org/licenses/by/2.0/"> <cc:permits rdf:resource="http://web.resource.org/cc/Reproduction"/> <cc:permits rdf:resource="http://web.resource.org/cc/Distribution"/> <cc:requires rdf:resource="http://web.resource.org/cc/Notice"/> <cc:requires rdf:resource="http://web.resource.org/cc/Attribution"/> <cc:permits rdf:resource="http://web.resource.org/cc/DerivativeWorks"/> </cc:License> <item rdf:about="http://www.biomedcentral.com/1471-2334/7/42"> <title>Hospital-acquired Clostridium difficile-associated disease in the intensive care unit setting: epidemiology, clinical course and outcome</title> <dc:title>Hospital-acquired Clostridium difficile-associated disease in the intensive care unit setting: epidemiology, clinical course and outcome</dc:title> <dc:creator>Marra, Alexandre R.</dc:creator> <dc:creator>Edmond, Michael B.</dc:creator> <dc:creator>Wenzel, Richard P.</dc:creator> <dc:creator>Bearman, Gonzalo M. L.</dc:creator> <dc:identifier>info:doi/10.1186/1471-2334-7-42</dc:identifier> <dc:source>BMC Infectious Diseases 2007, 7:42</dc:source> <dc:date>2007-05-21</dc:date>
    BMC Infectious Diseases</prism:publicationName>
    2007-05-21</prism:publicationDate>
    7</prism:volume>
    1</prism:number>
    Research article</prism:section>
    42</prism:startingPage> </item> </rdf:RDF> -->.</td> </tr> </tbody></table>Hospital-acquired Clostridium difficile-associated disease in the intensive care unit setting: epidemiology, clinical course and outcome
    Alexandre R. Marra , Michael B. Edmond , Richard P. Wenzel and Gonzalo M. L. Bearman

    BMC Infectious Diseases 2007, 7:42 doi:10.1186/1471-2334-7-42

    <table class="smalltext" cellpadding="0" cellspacing="0"><tbody><tr> <td>Published</td> <td width="25"> </td> <td>21 May 2007</td> </tr> </tbody></table>
    Abstract (provisional)

    The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.

    Background
    Clostridium difficile-associated disease (CDAD) is a serious nosocomial infection, however few studies have assessed CDAD outcome in the intensive care unit (ICU). We evaluated the epidemiology, clinical course and outcome of hospital-acquired CDAD in the critical care setting.
    Methods
    We performed a historical cohort study on 58 adults with a positive C. difficile cytotoxin assay result occurring in intensive care units.
    Results
    Sixty-two percent of patients had concurrent infections, 50% of which were bloodstream infections. The most frequently prescribed antimicrobials prior to CDAD were anti-anaerobic agents (60.3%). Septic shock occurred in 32.8% of CDAD patients. The in-hospital mortality was 27.6%. Univariate analysis revealed that SOFA score, at least one organ failure and age were predictors of mortality. Charlson score greater than or equal to 3, gender, concurrent infection, and number of days with diarrhea before a positive C. difficile toxin assay were not significant predictors of mortality on univariate analysis. Independent predictors for death were SOFA score at infection onset (per 1-point increment, OR 1.40; CI95 1.13-1.75) and age (per 1-year increment, OR 1.10; CI95 1.02-1.19).
    Conclusions
    In ICU patients with CDAD, advanced age and increased severity of illness at the onset of infection, as measured by the SOFA score, are independent predictors of death.


    http://www.biomedcentral.com/content...-2334-7-42.pdf
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