Risk Factors for Recurrence of Clostridium difficile Infection: Effect of Vancomycin-resistant Enterococci Colonization.
10.3346/jkms.2011.26.7.859
- Author:
Hee Kyoung CHOI
1
;
Kye Hyung KIM
;
Sun Hee LEE
;
Su Jin LEE
Author Information
1. Department of Internal Medicine, Division of Infections Disease, Medical Research Institute, Pusan National University School of Medicine, Busan, Korea. beauty192@hanmail.net
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Clostridium difficile;
Recurrence;
Risk factors;
VRE
- MeSH:
Adolescent;
Adult;
Aged;
Aged, 80 and over;
Anti-Bacterial Agents/*therapeutic use;
*Clostridium difficile;
Cohort Studies;
Enterococcus/*isolation & purification;
Enterocolitis, Pseudomembranous/drug therapy/*etiology/mortality;
Feces/microbiology;
Female;
Hemoglobins/analysis;
Hospital Mortality;
Humans;
Logistic Models;
Male;
Middle Aged;
Odds Ratio;
Recurrence;
Retrospective Studies;
Risk Factors;
Vancomycin/*therapeutic use;
*Vancomycin Resistance
- From:Journal of Korean Medical Science
2011;26(7):859-864
- CountryRepublic of Korea
- Language:English
-
Abstract:
Recurrent Clostridium difficile infection (CDI) is one of the most difficult problems in healthcare infection control. We evaluated the risk factors associated with recurrence in patients with CDI. A retrospective cohort study of 84 patients with CDI from December 2008 through October 2010 was performed at Pusan National University Yangsan Hospital. Recurrence occurred in 13.1% (11/84) of the cases and in-hospital mortality rate was 7.1% (6/84). Stool colonization with vancomycin-resistant enterococci (VRE) (P = 0.006), exposure to more than 3 antibiotics (P = 0.009), low hemoglobin levels (P = 0.025) and continued use of previous antibiotics (P = 0.05) were found to be more frequent in the recurrent group. Multivariate analysis indicated that, stool VRE colonization was independently associated with CDI recurrence (odds ratio, 14.519; 95% confidence interval, 1.157-182.229; P = 0.038). This result suggests that stool VRE colonization is a significant risk factor for CDI recurrence.
