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 ; 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