Session Type: ePosters
Session Title: ePosters
Authors(s): L. Samadan (1), M. Jelicic (2), A. Vince (2, 1), N. Papic (2, 1)
Authors Affiliations(s): (1) School of medicine, University of Zagreb, Croatia, (2) University hospital for infectious diseases Zagreb, Croatia
Background:
Recurrent Clostridioides difficile infections (rCDI) cause substantial impact on health-care systems with limited and often expensive therapeutic options. This requires identification of patients at high risks of rCDI. Nonalcoholic fatty liver disease (NAFLD) affects about 25% of adult population and is associated with metabolic syndrome, changes in gut microbiome and bile acids biosynthesis, all possibly related with increased susceptibility to CDI that has not been investigated. The aim of this study was to determine whether liver steatosis is a risk factor associated with rCDI.
Methods:A retrospective, cohort study included patients ≥ 60 years hospitalized with CDI in a 36-month period who underwent an abdominal ultrasonography examination during hospitalization. The cohort was divided into two groups: those who were and were not readmitted with CDI within six months of discharge.
Results:Of the 245 patients included, 79 patients (32.24%) experienced a rCDI (total of 124 episodes). Patients with rCDI were older (78 years, IQR 74-84 vs 77 years, 71-81), had higher Charlson Age-Comorbidity Index (CACI) (6 [4-7] vs 5 [4-6]) and were more frequently hospitalized within 3 months (81.01% vs 66.27%). Except for chronic kidney disease (25.32% vs 14.46%) and liver steatosis (31.65% vs 16.87%) which were more frequent in rCDI group, there were no differences in other comorbidities. Number of antibiotic classes used per patient and duration of therapy prior the first episode of CDI were similar, except for 3rd generation cephalosporins which were more frequently prescribed in rCDI group (21.52% vs 10.8%). There was no difference in the choice of CDI treatment; 100 patients were treated with metronidazole, 133 with vancomycin and 12 with combined therapy. 34 patients were metronidazole unresponsive and were switched to vancomycin. Logistic regression analysis showed that age >75 years (OR 2.08, 95%CI 1.04-4.29), CACI >6 (OR 2.62, 95%CI 1.30-5.38), liver steatosis (OR 2.38, 95%CI 1.03-5.20) and immobility (OR 2.61, 95%CI 1.23-5.75) were associated with rCDI. Other components of metabolic syndrome or choice of CDI treatment was not associated with rCDI in our cohort.
Conclusions:Our study identified liver steatosis as a new host-related risk factor associated with rCDI.
Keyword(s): Clostridioides difficile, Liver steatosis, Recurrent Clostridioides assocaited diseaseCOI Other: This publication was in part supported by the Croatian Science Foundation project titled “The role of immune semaphorins in NAFLDand sepsis” (principal investigator Neven Papic, project number UIP-2019-04-7194).
Session Type: ePosters
Session Title: ePosters
Authors(s): L. Samadan (1), M. Jelicic (2), A. Vince (2, 1), N. Papic (2, 1)
Authors Affiliations(s): (1) School of medicine, University of Zagreb, Croatia, (2) University hospital for infectious diseases Zagreb, Croatia
Background:
Recurrent Clostridioides difficile infections (rCDI) cause substantial impact on health-care systems with limited and often expensive therapeutic options. This requires identification of patients at high risks of rCDI. Nonalcoholic fatty liver disease (NAFLD) affects about 25% of adult population and is associated with metabolic syndrome, changes in gut microbiome and bile acids biosynthesis, all possibly related with increased susceptibility to CDI that has not been investigated. The aim of this study was to determine whether liver steatosis is a risk factor associated with rCDI.
Methods:A retrospective, cohort study included patients ≥ 60 years hospitalized with CDI in a 36-month period who underwent an abdominal ultrasonography examination during hospitalization. The cohort was divided into two groups: those who were and were not readmitted with CDI within six months of discharge.
Results:Of the 245 patients included, 79 patients (32.24%) experienced a rCDI (total of 124 episodes). Patients with rCDI were older (78 years, IQR 74-84 vs 77 years, 71-81), had higher Charlson Age-Comorbidity Index (CACI) (6 [4-7] vs 5 [4-6]) and were more frequently hospitalized within 3 months (81.01% vs 66.27%). Except for chronic kidney disease (25.32% vs 14.46%) and liver steatosis (31.65% vs 16.87%) which were more frequent in rCDI group, there were no differences in other comorbidities. Number of antibiotic classes used per patient and duration of therapy prior the first episode of CDI were similar, except for 3rd generation cephalosporins which were more frequently prescribed in rCDI group (21.52% vs 10.8%). There was no difference in the choice of CDI treatment; 100 patients were treated with metronidazole, 133 with vancomycin and 12 with combined therapy. 34 patients were metronidazole unresponsive and were switched to vancomycin. Logistic regression analysis showed that age >75 years (OR 2.08, 95%CI 1.04-4.29), CACI >6 (OR 2.62, 95%CI 1.30-5.38), liver steatosis (OR 2.38, 95%CI 1.03-5.20) and immobility (OR 2.61, 95%CI 1.23-5.75) were associated with rCDI. Other components of metabolic syndrome or choice of CDI treatment was not associated with rCDI in our cohort.
Conclusions:Our study identified liver steatosis as a new host-related risk factor associated with rCDI.
Keyword(s): Clostridioides difficile, Liver steatosis, Recurrent Clostridioides assocaited diseaseCOI Other: This publication was in part supported by the Croatian Science Foundation project titled “The role of immune semaphorins in NAFLDand sepsis” (principal investigator Neven Papic, project number UIP-2019-04-7194).
Session Type: ePosters
Session Title: ePosters
Authors(s): L. Samadan (1), M. Jelicic (2), A. Vince (2, 1), N. Papic (2, 1)
Authors Affiliations(s): (1) School of medicine, University of Zagreb, Croatia, (2) University hospital for infectious diseases Zagreb, Croatia
Background:
Recurrent Clostridioides difficile infections (rCDI) cause substantial impact on health-care systems with limited and often expensive therapeutic options. This requires identification of patients at high risks of rCDI. Nonalcoholic fatty liver disease (NAFLD) affects about 25% of adult population and is associated with metabolic syndrome, changes in gut microbiome and bile acids biosynthesis, all possibly related with increased susceptibility to CDI that has not been investigated. The aim of this study was to determine whether liver steatosis is a risk factor associated with rCDI.
Methods:A retrospective, cohort study included patients ≥ 60 years hospitalized with CDI in a 36-month period who underwent an abdominal ultrasonography examination during hospitalization. The cohort was divided into two groups: those who were and were not readmitted with CDI within six months of discharge.
Results:Of the 245 patients included, 79 patients (32.24%) experienced a rCDI (total of 124 episodes). Patients with rCDI were older (78 years, IQR 74-84 vs 77 years, 71-81), had higher Charlson Age-Comorbidity Index (CACI) (6 [4-7] vs 5 [4-6]) and were more frequently hospitalized within 3 months (81.01% vs 66.27%). Except for chronic kidney disease (25.32% vs 14.46%) and liver steatosis (31.65% vs 16.87%) which were more frequent in rCDI group, there were no differences in other comorbidities. Number of antibiotic classes used per patient and duration of therapy prior the first episode of CDI were similar, except for 3rd generation cephalosporins which were more frequently prescribed in rCDI group (21.52% vs 10.8%). There was no difference in the choice of CDI treatment; 100 patients were treated with metronidazole, 133 with vancomycin and 12 with combined therapy. 34 patients were metronidazole unresponsive and were switched to vancomycin. Logistic regression analysis showed that age >75 years (OR 2.08, 95%CI 1.04-4.29), CACI >6 (OR 2.62, 95%CI 1.30-5.38), liver steatosis (OR 2.38, 95%CI 1.03-5.20) and immobility (OR 2.61, 95%CI 1.23-5.75) were associated with rCDI. Other components of metabolic syndrome or choice of CDI treatment was not associated with rCDI in our cohort.
Conclusions:Our study identified liver steatosis as a new host-related risk factor associated with rCDI.
Keyword(s): Clostridioides difficile, Liver steatosis, Recurrent Clostridioides assocaited diseaseCOI Other: This publication was in part supported by the Croatian Science Foundation project titled “The role of immune semaphorins in NAFLDand sepsis” (principal investigator Neven Papic, project number UIP-2019-04-7194).
Session Type: ePosters
Session Title: ePosters
Authors(s): L. Samadan (1), M. Jelicic (2), A. Vince (2, 1), N. Papic (2, 1)
Authors Affiliations(s): (1) School of medicine, University of Zagreb, Croatia, (2) University hospital for infectious diseases Zagreb, Croatia
Background:
Recurrent Clostridioides difficile infections (rCDI) cause substantial impact on health-care systems with limited and often expensive therapeutic options. This requires identification of patients at high risks of rCDI. Nonalcoholic fatty liver disease (NAFLD) affects about 25% of adult population and is associated with metabolic syndrome, changes in gut microbiome and bile acids biosynthesis, all possibly related with increased susceptibility to CDI that has not been investigated. The aim of this study was to determine whether liver steatosis is a risk factor associated with rCDI.
Methods:A retrospective, cohort study included patients ≥ 60 years hospitalized with CDI in a 36-month period who underwent an abdominal ultrasonography examination during hospitalization. The cohort was divided into two groups: those who were and were not readmitted with CDI within six months of discharge.
Results:Of the 245 patients included, 79 patients (32.24%) experienced a rCDI (total of 124 episodes). Patients with rCDI were older (78 years, IQR 74-84 vs 77 years, 71-81), had higher Charlson Age-Comorbidity Index (CACI) (6 [4-7] vs 5 [4-6]) and were more frequently hospitalized within 3 months (81.01% vs 66.27%). Except for chronic kidney disease (25.32% vs 14.46%) and liver steatosis (31.65% vs 16.87%) which were more frequent in rCDI group, there were no differences in other comorbidities. Number of antibiotic classes used per patient and duration of therapy prior the first episode of CDI were similar, except for 3rd generation cephalosporins which were more frequently prescribed in rCDI group (21.52% vs 10.8%). There was no difference in the choice of CDI treatment; 100 patients were treated with metronidazole, 133 with vancomycin and 12 with combined therapy. 34 patients were metronidazole unresponsive and were switched to vancomycin. Logistic regression analysis showed that age >75 years (OR 2.08, 95%CI 1.04-4.29), CACI >6 (OR 2.62, 95%CI 1.30-5.38), liver steatosis (OR 2.38, 95%CI 1.03-5.20) and immobility (OR 2.61, 95%CI 1.23-5.75) were associated with rCDI. Other components of metabolic syndrome or choice of CDI treatment was not associated with rCDI in our cohort.
Conclusions:Our study identified liver steatosis as a new host-related risk factor associated with rCDI.
Keyword(s): Clostridioides difficile, Liver steatosis, Recurrent Clostridioides assocaited diseaseCOI Other: This publication was in part supported by the Croatian Science Foundation project titled “The role of immune semaphorins in NAFLDand sepsis” (principal investigator Neven Papic, project number UIP-2019-04-7194).