1.Risk Factors for Recurrence of Clostridium difficile Infection: Effect of Vancomycin-resistant Enterococci Colonization.
Hee Kyoung CHOI ; Kye Hyung KIM ; Sun Hee LEE ; Su Jin LEE
Journal of Korean Medical Science 2011;26(7):859-864
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.
Adolescent
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Adult
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Aged
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Aged, 80 and over
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Anti-Bacterial Agents/*therapeutic use
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*Clostridium difficile
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Cohort Studies
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Enterococcus/*isolation & purification
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Enterocolitis, Pseudomembranous/drug therapy/*etiology/mortality
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Feces/microbiology
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Female
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Hemoglobins/analysis
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Hospital Mortality
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Humans
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Logistic Models
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Male
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Middle Aged
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Odds Ratio
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Recurrence
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Retrospective Studies
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Risk Factors
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Vancomycin/*therapeutic use
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*Vancomycin Resistance