<- Home <- Arhive <- Vol. 26, Issue 3, September 2018



Rom J Leg Med26(3)288-294(2018)
DOI:10.4323/rjlm.2018.288
© Romanian Society of Legal Medicine


Medico-legal implications of medical treatments and infection preventions missteps resulting in Clostridium difficile Infection

T. Olariu, C. Precup, I. Olariu, I. R. Toma, V. Toma , D. G. Negru, E. D. Popovici , L. Timis, C. F. Ifrim


Abstract: Introduction. Clostridium difficile infection (CDI) was previously considered a nosocomial infection associated with antibiotic exposure, but now is more present in the communities and is obviously associated with acid-suppressive therapies. CDIs are common both in hospitalized and ambulatory patients, in nursing homes residents, being initiated by antibiotics and acid-suppressive therapies. Material and methods. A retrospective chart review of medical records for all inpatients of Arad Clinical County Hospital aged over 18 years, positive for C. difficile toxin, from January 2016 through June 2018, (30 months) was performed, to determine risks factors involved in CDIs cases with exitus, starting from the hypothesis that death rates for CDIs patients are higher in those with Proton Pump Inhibitors (PPIs) and antibiotic associations regimens prior to disease onset. Results. There were 221 CDIs cases registered in this period. Death rate was 17,19. Death Odds Ratio was extremely high for those with CDIs complications (40,75), for residents of nursing homes (5,615), for those who had had previous hospital contacts (3,165) and for those with PPIs regimens. Death Relative Risks was double for the elderly compared to adults (2,177), and for hospital contacts patients versus others (2,301) PPIs raised this risk to 1,869 and being nursing homes residents to 3,8642. Nososcomials cases reached 57,46%; possible iatrogenic causes were found in 23,98 of cases. Conclusions. When a patient has host-related risk factors for CDI, clinical and iatrogenic procedures can add crucial elements for the development of a Clostridium difficile infection
Keywords: CDI, nosocomiality, Odds ratio



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