Stămăteanu Lidia Oana, Miftode Ionela Larisa, Pleşca Claudia Elena, Hurmuzache Mihnea Eudoxiu, Manciuc Doina Carmen, Leca Daniela, Miftode Egidia Gabriela
Doctoral School, University of Medicine and Pharmacy Gr. T. Popa, 700115 Iași, Romania.
"St. Chiriachi" County Emergency Hospital, 730006 Vaslui, Romania.
Microorganisms. 2025 Jun 13;13(6):1377. doi: 10.3390/microorganisms13061377.
infection (CDI), the most common cause of nosocomial diarrhea, presents with a wide spectrum of clinical manifestations, ranging from mild diarrhea to severe, life-threatening conditions such as pseudomembranous colitis and toxic megacolon. In recent years, both the incidence and severity of CDI have increased, leading to a significant burden in terms of morbidity, mortality, and healthcare costs. We conducted a single-center, retrospective cohort study for 30 months at "Sf. Parascheva" Infectious Diseases Clinical Hospital Iași, in North Eastern Romania, aiming to assess the clinical and laboratory characteristics of CDI, as well as treatment approaches and their association with patient outcomes. A total of 534 patients were included during the study period, of whom 484 had favorable outcomes, while 50 have died of the disease. Fever ( = 0.007) and age over 65 ( = 0.001) were associated with prolonged hospitalization. Patients positive for both A and B toxins and GDH had the highest risk of recurrence ( = 0.020). Among comorbidities, obesity was the only condition significantly linked to recurrence ( = 0.001). In female patients over 65 years old, the probability of survival drops below 60% after 21 days of hospitalization, highlighting a critical risk factor in this population. These results underscore the importance of comprehensive risk assessment in CDI, particularly focusing on advanced age and comorbidities, to guide early therapeutic interventions, optimize patient management, and improve clinical outcomes among high-risk populations.
艰难梭菌感染（CDI）是医院获得性腹泻最常见的病因，临床表现多样，从轻度腹泻到严重的、危及生命的状况，如假膜性结肠炎和中毒性巨结肠。近年来，CDI的发病率和严重程度均有所上升，在发病率、死亡率和医疗费用方面造成了重大负担。我们在罗马尼亚东北部雅西的“Sf. Parascheva”传染病临床医院进行了一项为期30个月的单中心回顾性队列研究，旨在评估CDI的临床和实验室特征，以及治疗方法及其与患者预后的关联。研究期间共纳入534例患者，其中484例预后良好，50例死于该病。发热（P = 0.007）和65岁以上（P = 0.001）与住院时间延长有关。A毒素、B毒素和谷氨酸脱氢酶（GDH）均呈阳性的患者复发风险最高（P = 0.020）。在合并症中，肥胖是唯一与复发显著相关的疾病（P = 0.001）。在65岁以上的女性患者中，住院21天后生存概率降至60%以下，突出了该人群中的一个关键危险因素。这些结果强调了CDI综合风险评估的重要性，特别是关注高龄和合并症，以指导早期治疗干预、优化患者管理并改善高危人群的临床结局。
