Abstract

Introduction

Clostridioides difficile typically arises from changes in the microbiota following antibiotic use and can be fatal, especially in hospitalized patients. This study investigates fatality and associated factors following C.difficile infection in hospitalized patients.

Materials and Methods

In this case-control study, the case group consists of deaths within 30 days, while the control group consists of survivors. Demographic and clinical data were compared between the two groups. Risk factors for 30-day fatality were analyzed using logistic regression and Kaplan-Meier survival analysis.

Results

A total of 67 adult patients were included in the study. All-cause mortality occurred in 14 (20.9%) patients within the 30 days of diagnosis. Procalcitonin>0.5 ng/mL at the onset of the episode [OR: 7.407 (1.487 - 39.906)], ongoing antibiotic therapy for infections other than C.difficile infection after the onset of a C.difficile infection episode [OR: 5.927 (1.053 - 33.357)], and the occurrence of C.difficile infection in the intensive care unit [OR: 4.800 (1.066 – 21.609)] were identified as independent risk factors for all-cause 30-day fatality. The impact of these three variables on 30-day fatality was also demonstrated using Kaplan-Meier survival analysis (log-rank test, p<0.05).

Conclusion

In conclusion, C.difficile infection that develops in hospitalized patients is significant due to its potential to cause mortality. The onset of C.difficile infection during an intensive care unit stay and elevated procalcitonin levels at the onset of the episode may be predictors of poor outcomes. The management of antibiotic use leading to C.difficile infection following its development may improve survival.