IMPLICATIONS OF ANTIBIOTHERAPY IN CLOSTRIDIUM DIFFICILE INFECTION TO HOSPITALIZED PATIENTS IN DOLJ COUNTY (ROMANIA)

Objectives. The paper presents the role of the antibiotic treatment and of the favoring factors independent on the antibiotherapy, identified in the occurrence of Clostridium difficile infection (CDI) in hospitalized cases in Dolj County. Material and method. Two groups of patients were analyzed: the CDI AB group (178 cases of CDI that received antibiotic treatment) and the CDI non AB group (36 CDI cases which did not receive antibiotic treatment) recorded between July 2014 and December 2016). Results. The antibiotherapy was a significant risk factor, registered at 83.2% of the cases. The classes of antibiotics associated with the onset of CDI were cephalosporins (73.5% of cases), quinolones (24.2%), penicillins (13.4%), tuberculostatics (6.1%), carbapenems (5.6%). The cases came from the general surgery sections (25.2%), pneumophtiziology (16.8%), intensive care (13.5%), neurology (12.1%), nephrology (6.1%), orthopedics (6.1%), cardiology (4.2%), plastic surgery (4.2%), urology (3.7%). CDI non AB recorded a higher percentage compared to CDI AB in the Intensive care sections (30.6% versus10.1%). The comparative analysis of the characteristics of the patients with CDI AB and CDI non AB did not reveal significant differences linked to the age, sex, interval between admission and onset of the symptoms, recent gastrointestinal surgery or taking antacids. Conclusions. The antibiotherapy is an important risk factor for CDI, cephalosporins and quinolones being frequently-involved. Being admitted to the intensive care unit and the severity of the underlying conditions had a significant role in the appearance of CDI in patients without exposure to antibiotics.