Clostridioides difficile infection in a long-term convalescence hospital: A real tale of pitfalls and outdated therapy

Abstract

Objective. The aim of the study was to know the char-acteristics and risk factors of Clostridioides difficile infection (CDI) in a long-term hospital is key to improve its manage-ment. Material and methods. Retrospective study with 37 pa-tients, along 43 months. We describe demographic variables, clinical data, time to diagnosis, treatment, and evolution. Results. Analysis of 46 episodes (37 patients, mean age=82.2 years). 77.8% were absolutely dependent, 41.7% had chronic kidney disease, 64.9% had received antibiotics in the previous three months, 40.5% received antibiotics at diagnosis. It was the first episode in 78.4%, and first recurrence in 21.6%. Therapy was started in the first 24 hours after diagnosis in 89.2%, mostly metronidazole. 83.3% recovered, 3 patients died from CDI, diagnosis was registered in the discharge report in 91.1%. Conclusions. Previous antibiotic therapy, high grade of dependency and renal failure were the main risk factors. There is room for improvement in CDI management at our hospital.