Abstract
Clostridium difficile infection (CDI) rates in the United States and the world have increased in the last decade, along with associated morbidity and mortality. CDI symptoms can range from mild diarrhea to severe cases including pseudomembranous colitis and toxic mega colon and death. We performed a retrospective study including 130 patients with multiple organ failure who developed Clostridium difficile infection, admitted to the Iasi Sf. Parascheva Infectious Diseases Hospital in the interval January 1st, 2014 – June 1st, 2016; in order to highlight the high incidence of it and showing how we can manage this situations. An increased number of patients with Clostridium difficile infection and multiple organ dysfunction, in 2015 and 2016 was noticed. The profile of the patient from our study is a female with the age over 65 years old, coming from the rural area. Many of the admitted cases were patients enrolled in Hemodialysis Center. Cardiovascular disease was the most common associated pathology (60.79%), followed by renal failure (42%). Charlson comorbidity index showed 3-4, for 97 cases. The specific antibiotherapy for CDI was administrated for 5-7 days to 21 days long. In 73% of the cases the CDI was treated, 17 cases recorded relapse, and one case died. Clostridium difficile is the most common enteric pathogen in hospitalized patients. Standardized procedures to implement hygienic measures and restricted use of antibiotics are necessary to control the widespread occurrence of CDI in immunocompromised renal patients.
Keywords: Clostridium difficile infection; multiple organ dysfunction; Charlson comorbidity index; metronidazole; vancomycin