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( Leonor Costa ),( Joana Costa ),( Deolinda Portelinha ),( Amilcar Silva ),( Adriano Rodrigues ) 대한내과학회 2014 대한내과학회 추계학술발표논문집 Vol.2014 No.1
Background: Clostridium difficile infection (CDI) is a frequent cause of infectious colitis, usually occurring as a complication of antibiotic therapy, in elderly hospitalized patients. Is responsible for signifi cant morbidity and mortality, and remains at historically high levels, being a serious re-emerging pathogen. Methods: Retrospective study of adult patients admitted in the Medical Department of a Hospital Center, between 2005 and 2012, that meet the defi nition of CDI. Results: 100 patients were included, with an average age of 78, 6 years (± 10, 76), 68% of female sex. By age group 79,0% of patients were over 70 years and 48,0% exceed 80 years. The overall mortality of the patient group was 21%, being the mortality attributable to the infection by Clostridium as the main diagnostic 8%. The main risk factor found for the disease development was recent treatment with one or more antibiotics, 81% of cases, without a predominant class of antibiotic. Regarding the origin of the infection 56% were nosocomial, 44% associated with health care and 8% had origin in the community. In patients who started therapy with metronidazole, in 12% was switched to vancomycin (ascending to 50% in the patients that died from the infection). Conclusions: The epidemiology of CDI, is changing with increase infections in lowrisk patients, and the rising of the fatal cases. Indentifi ng CDI earlier is essencial, and saves lifes. Measures like prescribing antibiotics only when apropriate, test for CDI in patients with diarrhea and isolation, are crucial, specially with the alarming reality of the rising resistance to metronidazol, the possible future vancomicin resistence with its overuse, and the present lack of new effective therapeutic options, making this opportunistic infecction, a clinical challenge in the present and in years to come.