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Hindi Research Article
Nosocomial Clostridium difficile Infection among Patients Over 90 Years Old
Yuji Hirai1,2*, Midori Miyamae2, Toru Yamada2 and Shin Takahashi2
1Department of General Medicine, Faculty of Medicine, Juntendo University, Japan
2Tokyo Metropolitan Health and Medical Treatment Corporation, Tama-Hokubu Medical Center, Infection Control Team, Japan
- *Corresponding Author:
- Yuji Hirai
Department of General Medicine, Faculty of Medicine
Juntendo University, Hongo, Bunkyo, Tokyo, Japan
Tel: +81-3-3813-3111
Fax: +81-3-5684-7830
E-mail: y-hirai@juntendo.ac.jp
Received date: August 25, 2017; Accepted date: September 05, 2017; Published date: September 09, 2017
Citation: Hirai Y, Miyamae M, Yamada T, Takahashi S (2017) Nosocomial Clostridium difficile Infection among Patients Over 90 Years Old. J Infect Dis Ther 5:333. doi: 10.4172/2332-0877.1000333
Copyright: © 2017 Hirai Y, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Aim: Ageing population trends indicate that the median life expectancy in Japan is increasing. Clostridium difficile infection (CDI) can be a fatal nosocomial infection among the geriatric population. We examined clinical outcome and risk factors associated with death due to CDI among patients >90 years old.
Methods: This retrospective observational study was performed to demonstrate the clinical characteristics of Patients >90 years who developed CDI between April 2010 and March 2015 at Tama-Hokubu Medical Center (a 344-bed community tertiary care hospital; average age of inpatients: 72 years). Diagnosis of CDI was confirmed via an enzyme-linked immunosorbent assay using stool sample. Multivariate analysis was performed to determine the independent risk factors associated with death.
Results: Twenty-nine patients with CDI confirmed were identified. The mean age was 93 (90–100) years and 37.9% were women. Patients presented with hypertension (37.9%) and diabetes (33%) as underlying diseases, and 93.1% were admitted from long-term care facilities. The median period from admission to onset of CDI was 14 (2– 73) days. The average episodes of diarrhea was 3.96 (1 to 10) times per day. The overall 90-day mortality rate was 34.5%. Multivariate analysis revealed that arrhythmia followed by onset of CDI (Odds Ratio, 8.0; 95% Confidence Interval, 1.37–46.8; P=0.021) was an independent risk factor associated with death.
Conclusions: Arrhythmia followed by onset of CDI is a risk factor for death. Strict clinical management, including continuous monitoring of electrolyte and fluid balance and careful observation of patients >90 years old is crucial.
