Our aim was to analyze characteristics of treatment failure with intravenous tigecycline monotherapy among adults with severe Clostridioides (Clostridium) difficile infection (CDI). A single-centre observational cohort study was performed between 2014 and 2018. Data were collected by charts review, diagnosis and severity were determined by ESCMID guidelines. Primary outcome was treatment failure, secondary outcomes were in-hospital mortality, relapse, colectomy, and complication rates. Independent predictors of failure were identified using logistic regression. Altogether 110 patients were included, failure occurred in 37.3%. Patients with failure frequently had chronic heart and pulmonary co-morbidities, peritonitis, higher CRP levels, ICU admittance rates and need for total parenteral nutrition and vasopressors. Mostly, CDI-specific mortality and complications contributed to failure. Relapse rates were similar. Chronic pulmonary disease, ileus, total parenteral nutrition, and duration of tigecycline therapy were predictors of failure. We conclude that severe CDI cases with higher risk for tigecycline monotherapy failure might be identified by contributing factors.

我们的目的是分析重度艰难梭菌（Clostridium）艰难梭菌成人静脉用替加环素单药治疗失败的特征感染（CDI）。在2014年至2018年之间进行了单中心观察性队列研究。通过图表审查收集数据，根据ESCMID指南确定诊断和严重性。主要结局为治疗失败，次要结局为院内死亡率，复发，结肠切除术和并发症发生率。使用逻辑回归确定了独立的故障预测因素。总共包括110例患者，失败发生率为37.3％。衰竭患者经常患有慢性心脏和肺部合并症，腹膜炎，较高的CRP水平，ICU入院率，以及需要总的肠胃外营养和血管加压药。通常，特定于CDI的死亡率和并发症是导致失败的原因。复发率相似。慢性肺部疾病，肠梗阻，肠胃外营养，替加环素治疗的时间和持续时间是失败的预测因素。我们得出的结论是，可以通过影响因素来确定严重的CDI病例，这些病例的替加环素单药治疗失败风险更高。