Long-Term Clinical Outcome of Clostridium difficile Infection in Hospitalized Patients: A Single Center Study.
- Author:
Young Seok DOH
1
;
You Sun KIM
;
Hye Jin JUNG
;
Young Il PARK
;
Jin Won MO
;
Hyun SUNG
;
Kyung Jin LEE
;
Young Ki SEO
;
Jeong Seop MOON
;
Seong Woo HONG
Author Information
- Publication Type:Original Article
- Keywords: Clostridium difficile; Recurrence; Mortality; Risk factors
- MeSH: Aging; Clostridium difficile*; Diagnosis; Follow-Up Studies; Humans; Incidence; Korea; Logistic Models; Medical Records; Mortality; Prognosis; Proton Pumps; Recurrence; Retrospective Studies; Risk Factors; Seoul
- From:Intestinal Research 2014;12(4):299-305
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: Antibiotic usage and increasingly aging populations have led to increased incidence of Clostridium difficile infection (CDI) in worldwide. Recent studies in Korea have also reported increasing CDI incidence; however, there have been no reports on the long-term outcomes of CDI. We therefore investigated the long-term clinical outcomes of patients with CDI, including delayed recurrence, associated risk factors and mortality. METHODS: Hospitalized patients diagnosed with CDI at Seoul Paik Hospital between January 2007 and December 2008 were included. Their medical records were retrospectively investigated. 'Delayed recurrence' was defined as a relapse 8 weeks after a successful initial treatment. Multivariate logistic regression analysis was performed to identify risk factors for the delayed recurrence. Kaplan-Meier curves were used to analyze mortality rates. RESULTS: A total of 120 patients were enrolled; among them, 87 were followed-up for at least 1 year, with a mean follow-up period of 34.1+/-25.1 months. Delayed recurrence was observed in 17 patients (19.5%), and significant risk factors were age (over 70 years, P=0.049), nasogastric tube insertion (P=0.008), and proton pump inhibitor or H2-blocker treatments (P=0.028). The 12- and 24-month mortality rates were 24.6% and 32.5%, respectively. No deaths were directly attributed to CDI. CONCLUSIONS: Delayed recurrence of CDI was not rare, occurring in 19.5% of the study population. Although CDI-related mortality was not reported, 2-year (32.5%) mortality rate of CDI patients implies that a CDI diagnosis may predict severe morbidity and poor prognosis of the underlying disease.
