Late poor outcomes of Clostridioides difficile infections in oncological patients: A multicentre cohort study

肿瘤患者艰难梭菌感染的晚期不良预后:一项多中心队列研究

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作者:Esther Calbo, Sergi Hernández, Nieves Sopena, Laia Castellá, Joaquín Lopez-Contreras, Jordi Cuquet, Maria López-Sánchez, Rafel Pérez, Carlota Gudiol, Ana Coloma, Mariló Marimón, Joan Espinach, Marta Andres, Purificación Martos, Gonçalo Carvalho Rodrigues, Enric Limón

Background

Cancer has been associated with an increased risk of in-hospital mortality in CDI patients. However, data on delayed mortality in cancer patients with CDI are scarce.

Discussion

Oncological patients presented a higher risk of poor outcomes after CDI. Their early and late mortality rates were higher than in the general population, and in parallel, those undergoing chemotherapy (especially those receiving metronidazole) had higher rates of recurrence.

Methods

A multicenter prospective cohort study was conducted in 28 hospitals participating in the VINCat program. Cases were all consecutive adult patients who met the case definition of CDI. Sociodemographic, clinical, and epidemiological variables and evolution at discharge and after 90 days were recorded for each case. Findings/

Objective

The aim of the present study was to compare outcomes between oncological patients and the general population with Clostridioides difficile infection (CDI) after 90 days of follow-up.

Results

The mortality rate was higher in oncological patients (OR = 1.70, 95% CI: 1.08-2.67). In addition, oncological patients receiving chemotherapy (CT) presented higher recurrence rates (18.5% vs 9.8%, p = 0.049). Among oncological patients treated with metronidazole, those with active CT showed a higher rate of recurrence (35.3% vs 8.0% p = 0.04).

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