Epidemiology and Clinical Characteristics of Clostridium difficile Infection in a Korean Tertiary Hospital.
10.3346/jkms.2011.26.10.1258
- Author:
Jieun KIM
1
;
Hyunjoo PAI
;
Mi ran SEO
;
Jung Oak KANG
Author Information
1. Department of Internal Medicine, Hanyang University College of Medicine, Guri, Korea.
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Clostridium difficile Infection;
Incidence;
Clinical Characteristics;
Toxin Type
- MeSH:
Aged;
Bacterial Proteins/analysis;
Bacterial Toxins/analysis;
Clostridium Infections/*epidemiology/physiopathology;
Clostridium difficile/*isolation & purification/*pathogenicity;
Diarrhea/epidemiology/microbiology;
Enterocolitis, Pseudomembranous/*epidemiology/microbiology/pathology;
Enterotoxins/analysis;
Feces/microbiology;
Female;
Hospitals;
Humans;
Incidence;
Male;
Metronidazole/therapeutic use;
Middle Aged;
Prospective Studies;
Recurrence;
Republic of Korea/epidemiology;
Treatment Outcome;
Vancomycin/therapeutic use
- From:Journal of Korean Medical Science
2011;26(10):1258-1264
- CountryRepublic of Korea
- Language:English
-
Abstract:
In order to investigate the incidence, clinical and microbiologic characteristics of Clostridium difficile infection (CDI) in Korea, a prospective observational study was performed. From September 2008 through January 2010, all patients whose stool was tested for toxin assay A&B and/or C. difficile culture were studied for clinical characteristics. Toxin types of the isolates from stool were tested. The mean incidence of CDI per 100,000 patient-days was 71.6 by month (range, 52.5-114.0), and the ratio of CDI to antibiotic-associated diarrhea was 0.23. Among 200 CDI patients, 37.5% (75/200) was severe CDI based on severity score. Clinical outcome of 189 CDI was as followed; 25.9% (49/189) improved without treatment, 84.3% (118/140) achieved clinical cure and attributed mortality was 0.7% (1/140) with the treatment. Recurrence rate was 21.4% (30/140) and cure without recurrence was 66.4% (93/140). The most common type of toxin was toxin A-positive/toxin B-positive strain (77.5%), toxin A-negative/toxin B-positive strains or binary toxin-producing strains comprised 15.4% or 7.1%, respectively. In conclusion, the incidence of CDI in Korea is a little higher than other reports during the non-epidemic setting. We expect that the change of epidemiology and clinical severity in CDI can be evaluated based on these results.
