Living with the tenant: Associated factors in Clostridium difficile infection with toxin and/or positive antigen in hospitalized elder patients

Background: In the last decades, Clostridium difficile (CDI) infection has become the causal agent of diarrhea with a great impact in morbi-mortality. Describe the associate factors of CDI in hospitalized patients with diarrhea samples and positive toxin or antigen tests, treatment outcomes, severity and mortality factors. Methods & Materials: Retrospective cases between september 2016 and september 2017. Inpatients with CDI toxin/ positive antigen in feces samples. C.DIFF QUICK CHECH COMPLETE immnunocromatographic rapid test was used for diagnosis and toxigenic culture (C-tcd). Possible associated factors to CDI: sex, age, comorbidities, previous antibiotics (p-ATB) and the admission, proton pumb inhibitors (PPI), histamine inhibitors (HI), days in hospital, severity markers (SM), leukocyte (BC) ≥ 15000 cel/mm3, albumin ≤3 g/dl and creatinine 1.4 mg/dl, CDI treatment and high mortality. The constant variables were described with media and standard deviation (SD) or media range time interval (IIQ) according to distribution. The categorical variables were expressed in total n and percentages. Results: In a total of 32 hospitalized patients with CDI the mean range age was 74 years-old (IIQ 67-80), men 15 (55,6%), comorbidities: diabetes mellitus 7 (26%), solid organs tumor 8 (29,6%), autoimmune disease 8 (29,6%), chronic kidney failure 6 (22%), days in hospital 9 (IIQ 3-21), PPI 25 (92,6%), HI 4 (14,8%). Positive ICT-Tcd 14 (51,8%), C-tcd 18 (66,7%), pathological abdominal ultrasound scan 7 (25,9%). The p-ATB 18 (66,7%): Carbapenemes 12 (44,4%), Piperaciline/tazobactam 10 (37%), Quinolones 6 (22,2%), Amoxiciline/clavulanic 13 (48.1%), Cefalosporines 5 (18,5%). The SM CDI: BC 9730 (IIQ 7900-13240), hypoalbuminaemia 14 (58,3%), acute renal failure 5 (18,5%). Treatment was metronidazol-vo 17 (63%), metronidazol-EV 7 (25,6%). Mortality at discharge: 8 (29,6%). Conclusion: CDI's current evidence in elder hospitalized population is limited. We were able to describe DCI associated factors, the importance of toxigenic culture in negative toxin samples in its first CDI lecture. We recommend to bear in mind the CDI in a diarrhea episode, identify a method of diagnosis and an optimization of infection control measures.