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• W2893513516 abstract "Age > 65 years is associated with the recurrence and poor prognosis of Clostridium difficile infection (CDI). Data on elderly patients (≥ 75 years) is scarce, and little is known about compliance with European guidelines in terms of specific treatment. We aimed to analyze the treatment and prognosis of CDI in two groups of patients aged < and ≥ 75 years. We performed a prospective survey from May 2014 to April 2015 in a university hospital including all patients presenting with microbiologically confirmed CDI. Sociodemographic and clinical data, treatment of CDI, recurrences (< 8 weeks after CDI treatment completion), new episodes, and mortality were recorded. Follow-up was performed until February 2016. Overall, 101 patients were included; 45 were aged ≥ 75 years (44.6%). More than two-thirds of CDIs (71/101) were severe. Seven per cent of patients presenting with severe CDI and 10% of patients at increased risk of recurrence received the adequate treatment as per European guidelines. Mean follow-up was 15 ± 4 months (range: 10–22). Among patients aged ≥ 75 years, we observed the same number of recurrences and new episodes of CDI during the follow-up. The 3-month case fatality was significantly higher in the elderly group (P < 0.001). The one-year survival rate was 73.2% in younger patients and 45.7% in elderly patients (P = 0.0004). This study confirms the poor prognosis of CDI in elderly patients and highlights the lack of compliance with treatment guidelines. L’âge > 65 ans est associé à un risque de récurrence et de mauvais pronostic des infections à Clostridium difficile (ICD). Les données concernant les patients ≥ 75 ans sont limitées et l’adéquation de la prise en charge thérapeutique des ICD aux recommandations européennes a été peu étudiée. Analyse du traitement et du pronostic des ICD en comparant deux groupes de patients âgés de < et ≥ 75 ans (mai 2014–avril 2015). Nous avons inclus tous les cas d’ICD confirmés microbiologiquement. Les données sociodémographiques et cliniques, le traitement, les récurrences (< 8 semaines après la fin du traitement), les nouveaux épisodes et la mortalité ont été recueillis. La cohorte a été suivie jusqu’en février 2016. Cent-un patients ont été inclus ; 45 âgés de ≥ 75 ans (44,6 %). Au total, 71/101 patients étaient graves, 7 % des patients ayant une ICD grave et 10 % des patients ayant un risque élevé de récurrence ont reçu un traitement adapté selon les recommandations européennes. Le suivi moyen était de 15 ± 4 mois (intervalle : 10–22). Avec une limite à 75 ans, le nombre de récurrences et d’épisodes ultérieurs d’ICD était identique dans les deux groupes. Le taux de mortalité à 3 mois était plus élevé chez les patients très âgés (p < 0,001). Le taux de survie à un an était de 73,2 % chez les patients < 75 ans et de 45,7 % chez ceux ≥ 75 ans (p = 0,0004). Cette étude souligne le mauvais pronostic des ICD chez les personnes âgées et la faible adéquation aux recommandations thérapeutiques." @default.
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• W2893513516 date "2019-05-01" @default.
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• W2893513516 title "Treatment compliance with European guidelines and prognosis of Clostridium difficile infection according to age" @default.
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• W2893513516 doi "https://doi.org/10.1016/j.medmal.2018.08.001" @default.
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