Klinička i epidemiološka obilježja Clostridioides difficile infekcije u djece i mladih odraslih do 29 godina

master's thesis

• Title (english): Clinical and epidemiological characteristics of Clostridioides difficile infection in children and young adults up to 29 years of age
• Author: Marin Glavčić
• Mentor: Mirjana Balen Topić (mentor)
• Committee member: Goran Tešović (predsjednik povjerenstva)
• Committee member: Josip Begovac (član povjerenstva)
• Committee member: Mirjana Balen Topić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Infectious Diseases); Zagreb
• Defense date and country: 2021-07-16, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Infectology

Abstract

UVOD: Clostridioides difficile (CD) je glavni infektivni uzročnik postantimikrobne dijareje (PAD) te incidencija i značaj infekcije uzrokovane s CD (CDI) rastu diljem svijeta. Za razliku od bolesnika starije životne dobi, epidemiološka i klinička obilježja CDI u djece i mladih odraslih su slabije istražene. ----- CILJ: Opisati epidemiološka i klinička obilježja te utvrditi odnos epidemioloških okolnosti razbolijevanja i kliničke težine bolesti i ishoda liječenja u bolesnika <30 godina s CDI. ----- MATERIJALI I METODE: Radi se o retrospektivnom deskriptivnom istraživanju provedenom na bolesnicima dobi <30 godina hospitalno liječenim zbog laboratorijski potvrđene CDI u razdoblju od godine 2013. – 2019. u Klinici za infektivne bolesti „Dr. Fran Mihaljević“. ----- REZULTATI: U ukupnom uzorku bolesnika s CDI, bolesnika dobi <30 godina je bilo 75/1811 (4%). Među njima je 61,3% bolesnika imalo CDI povezanu sa zdravstvenom skrbi, 34,7% izvanbolnički stečenu CDI, a kod 4,0% se epidemiološke okolnosti razbolijevanja nisu mogle utvrditi. U promatranom razdoblju nije bilo značajnog trenda rasta udjela bolesnika s CDI povezanom sa zdravstvenom skrbi (p=0,661), no oni su bili značajno dulje hospitalizirani u odnosu na bolesnike s izvanbolnički stečenom CDI (srednja vrijednost hospitalizacije: 21,8 vs. 9,8 dana) (p=0,007). Stopa smrti bolesnika s CDI <30 godina je bila 6,7%, dok je u populaciji djece (<18 godina) bila 2,2%. ----- ZAKLJUČAK: Rezultati ove studije pokazuju da su među bolesnicima dobi <30 godina najčešće bile CDI povezane sa zdravstvenom skrbi, no njihov udio nije značajnije rastao u promatranom razdoblju te nije bilo značajne razlike u kliničkoj težini i prisutnim komplikacijama CDI unutar promatranih skupina po epidemiološkom načinu razbolijevanja. Analizom ishoda liječenja među promatranim skupinama nije utvrđena razlika u stopi smrti, kao niti razlika u potrebi za liječenjem u jedinici intezivnog liječenja zbog same CDI, no utvrđeno je statistički značajno duže trajanje hospitalizacije u bolesnika koji su imali CDI povezanu sa zdravstvenom skrbi.

Abstract (english)

INTRODUCTION: Clostridioides difficile (CD) is a major infectious agent of postantimicrobial diarrhea (PAD) and the incidence and importance of infection caused by CD (CDI) is growing worldwide. In contrast to elderly patients, the epidemiological and clinical features of CDI in children and young adults are less well studied. ----- OBJECTIVE: To describe the epidemiological and clinical features and to determine the relationship between the epidemiological circumstances of the disease and the clinical severity of the disease and the treatment outcome in patients <30 years with CDI. ----- MATERIALS AND METHODS: This is a retrospective descriptive study conducted on patients <30 years of age hospitalized for laboratory-confirmed CDI in the period from 2013 to 2019 at the University Hospital for Infectious Diseases "Dr. Fran Mihaljević“. ----- RESULTS: In the total sample of patients with CDI, patients aged <30 years were 75/1811 (4%). Among them, 61.3% had health care associated CDI, 34.7% community-acquired CDI, and in 4.0% the epidemiological circumstances of the disease could not be determined. In the observed period, there was no significant trend of increase in the proportion of patients with health care associated CDI (p = 0.661), but they were significantly longer hospitalized compared to patients with community-acquired CDI (mean hospitalization: 21.8 vs. 9.8 days) (p = 0.007). The mortality rate of patients with CDI <30 years was 6.7%, while in the population of children (<18 years) it was 2.2%. ----- CONCLUSION: The results of this study show that among patients aged <30 years the most common were health care associated CDI, but their proportion has not increased significantly during observed period, and there was no significant difference neither in clinical severity nor in CDI complications among groups according to epidemiological circumstances of the disease development. The analysis of treatment outcomes between the observed epidemiological groups did not reveal a difference in the mortality rate, nor a difference in the need for treatment in intensive care unit due to CDI, but statistically significantly longer duration of hospitalization in patients with health care associated CDI was found.

• Keywords: Clostridioides difficile; C. difficile infekcija; djeca; mladi odrasli; ishod
• Keywords (english): Clostridioides difficile; C. difficile infection; children; young adults; outcome
• Language: croatian
• URN:NBN: urn:nbn:hr:105:786341
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2022-02-03 11:38:19