outcome of icu patients with clostridium difficile infection梭状芽胞杆菌的结果icu患者感染.pdfVIP

Zahar et al. Critical Care 2012, 16:R215 /content/16/6/R215 RESEARCH Open Access Outcome of ICU patients with Clostridium difficile infection 1,2 5 3 1,4 1 Jean-Ralph Zahar , Carole Schwebel , Christophe Adrie , Maité Garrouste-Orgeas , Adrien Français , 1 1 1,5 1,6 7,8 Aurélien Vesin , Molière Nguile-Makao , Alexis Tabah , Kevin Laupland , Alban Le-Monnier and Jean-François Timsit1,3,5*, for the OUTCOMEREA study group Abstract Introduction: As data from Clostridium difficile infection (CDI) in intensive care unit (ICU) are still scarce, our objectives were to assess the morbidity and mortality of ICU-acquired CDI. Methods: We compared patients with ICU-acquired CDI (watery or unformed stools occurring ≥ 72 hours after ICU admission with a stool sample positive for C. difficile toxin A or B) with two groups of controls hospitalized at the same time in the same unit. The first control group comprised patients with ICU-acquired diarrhea occurring ≥ 72 hours after ICU admission with a stool sample negative for C. difficile and for toxin A or B. The second group comprised patients without any diarrhea. Results: Among 5,260 patients, 512 patients developed one episode of diarrhea. Among them, 69 (13.5%) had a CDI; 10 (14.5%) of them were community-acquired, contrasting with 12 (17.4%) that were hospital-acquired and 47 (68%) that were ICU-acquired. A pseudomembranous colitis was associated in 24/47 (51%) ICU patients. The median delay between diagnosis and metronidazole administration was one day (25th Quartile; 75th Quartile (0; 2) da