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Volume 3 Supplement 1

ESICM LIVES 2015

  • Poster presentation
  • Open Access

Clinical impact and outcome of clostridium non-difficile infection in critically ill patients

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Intensive Care Medicine Experimental20153 (Suppl 1) :A117

https://doi.org/10.1186/2197-425X-3-S1-A117

  • Published:

Keywords

  • Septic Shock
  • Renal Replacement Therapy
  • Soft Tissue Infection
  • Intensive Care Unit Mortality
  • Microbiological Culture

Introduction

Clostridium species are gram-positive, anaerobic, spore-forming bacteria and some species have pathogenic nature. There is limited data regarding Clostridium non-difficile infection in critically ill patients available. Symptoms of infection are often non-specific, which leads to delayed diagnosis and therapy initiation in these patients.

Objectives

Aim of this study was to evaluate patients with positive microbiological cultures of Clostridium non-difficile infection with the need of critical care medicine.

Methods

Patients with microbiological result of Clostridium non- difficile infection admitted to the intensive care unit (ICU) were included in this study. Patient´s characteristics including admission diagnosis, severity of illness (SOFA- score), therapeutic procedures and outcome were recorded.

Results

A total of 47 critically ill patients (32 men, mean age 66 ± 9 years, mean SOFA-score on admission 9 ± 3) with Clostridium non-difficile infection were included in this study. The most common pathogens were Clostridium innocum (n = 23), Clostridium perfringens (n = 11), Clostridium tertium (n = 6) and others (n = 7). Pathogens were detected in 62% intra-abdominal, in 29% in blood cultures and 8% of patients had soft tissue infection. Intra-abdominal infections (71%) were the most common source of infection.

Admission diagnoses were septic shock (54%), surgical treatment (44%) and others (2%). Highest incidence of septic shock was seen in patients with Clostridium innocum infection, (p < 0.05). Preexisting, mostly abdominal (90%) malignancy was seen in 46% of these patients. Invasive ventilation was needed in 50%, vasopressor therapy in 71% and renal replacement therapy in 38%. The overall ICU mortality was 45%. Highest ICU mortality rate was found in patients with Clostridium innocum infection (45%), followed by Clostridium perfringens (23%) and Clostridium tertium (17%). Patients with septic shock showed significantly higher mortality rates (p < 0.05). By means of source of infection highest mortality rate was found in abdominal infection (65%) followed by bacteremia (43%).

Conclusions

Clostridium non-difficile infection in critically ill patients is associated with high mortality and organ failure. Worst outcome was observed in patients with septic shock.

Authors’ Affiliations

(1)
Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

Copyright

© Rutter et al.; 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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