The analysis of protein deficiency in patients hospitalized due to Clostridium difficile infection
Journal Title: Postępy Nauk Medycznych - Year 2014, Vol 27, Issue 11
Abstract
Introduction. Clostridium difficile infections are one of the major causes of bacterial diarrhoea, particularly in patients aged over 65 years. Hospitalization time depends not only on the severity of the diarrhoea, but mainly on the decompensation of the general status of patients with concurrent chronic diseases. Protein-losing enteropathy, a complication resulting from the exposure of the intestines to toxins released by C. difficile, leads to a considerable loss of protein, particularly the albumin fraction, and deterioration of the patient’s general health.Aim. The aim of this study was to evaluate protein deficiency in patients with CDI and to identify the risk factors for such disorders related to demographic and iatrogenic parameters.Material and methods. The retrospective analysis of C. difficile-associated diarrhoea (CDAD) among patients hospitalized at the Department of Infectious Diseases (J. Struś Multispecialist City Hospital, Poznań) in 2013.An episode of CDI was diagnosed based on the recommendations of the experts.The aetiology of Clostridium difficile-associated diarrhoea was confirmed using TECHLAB immunoenzymatic tests, i.e. a rapid membrane-based assay detecting the glutamate dehydrogenase (GDH) antigen and a rapid assay detecting toxins A and B from C. difficile. Protein metabolism was evaluated based on the measured total protein or albumin levels in blood plasma.Protein disorders were analysed depending on the age and sex of patients, the duration and severity of the diarrhoea, and inflammatory markers, i.e. levels of C-reactive protein and leukocytosis. The correlation between the creatinine levels and risk factors for CDI was also tested.Test results were analysed using the Shapiro-Wilk and Mann-Whitney tests.Results. Deficiency in total protein and albumin levels was found in 28 (71,8%) of patients from the studied population. Total protein deficiency correlated with deficiency of the albumin fraction, while the severity of the deficiency depended on the duration of the diarrhoea, and not on the daily number of passed stools. No evidence supporting the assumed correlation between the protein deficiency and the patient’s age, renal function or the levels of inflammatory markers (C-reactive protein and leukocytosis) was found.Conclusions. CDI is a systemic disease correlated with protein loss. Because of the patient’s age and numerous concomitant diseases, CDI poses a serious threat to the patient’s life, and in each case requires the evaluation of protein metabolism.
Authors and Affiliations
Błażej Rozpłochowski, Olga Słyńko-Medoń, Michał Chojnicki, Agnieszka Seraszek-Jaros, Arleta Kowala-Piaskowska, Iwona Mozer-Lisewska
Keywords
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