• Cláudia Nazareth, Inês Leitão, Ernestina Reis, Hugo Inácio, Filomena Martins, Elmano Ramalheira, Flávia Cunha, Carla Santos, Sara Lino, Hugo Moreira, Nadiya Kruptsala, Andrea Santos, Laura Paixão, Leonor Pássaro, and Mónica Oleastro.
• Unidade de Prevenção de Controlo de Infeções e Resistências aos Antimicrobianos. Centro Hospitalar e Universitário de Coimbra. Coimbra. Portugal.
• Acta Medica Port. 2022 Apr 1; 35 (4): 270-278.

IntroductionClostridioides difficile is the main cause of healthcare-associated diarrhea in Europe and North America. The aim of this study was to characterize the epidemiology and clinical burden of Clostridioides difficile infection among hospitalized patients in Portugal.Material And MethodsRetrospective study conducted in six public hospital centers in Portugal. All primary Clostridioides difficile infection episodes and related recurrences occurring in 2017, as well as episodes developing two to eight weeks after the last episode diagnosed in that year, were documented. The National Reference Laboratory (National Institute of Health Dr. Ricardo Jorge) provided national surveillance data on Clostridioides difficile infection.ResultsA total of 385 inpatients with at least one primary episode diagnosed in 2017 were included. Most patients were aged over 70 years-old (73.2%). The included patients developed 451 episodes during the observation period. Approximately 44% of primary episodes were community-associated. Most episodes (94.9%) occurred in patients with one or more risk factors, with recent antibiotic exposure being particularly common (86.0%). All-cause in-hospital mortality was 19.5%, being significantly higher in patients aged over 65 years-old versus those aged 18 to 64 years-old (22.4% vs 7.8%, respectively). Over 50 different ribotypes were observed among 206 Clostridioides difficile strains received by the National Reference Laboratory.ConclusionIn Portugal, hospitalized patients with Clostridioides difficile infection are mostly older patients presenting risk factors for the development of this infection, particularly recent antibiotic exposure. Mortality is disproportionately high among the older population. Community-associated Clostridioides difficile infection is common among inpatients with this infection.

18 keywords...

hide…