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Vol. 16. Issue 3.
La Mucoviscidose
Pages 256-261 (May - June 2012)
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Vol. 16. Issue 3.
La Mucoviscidose
Pages 256-261 (May - June 2012)
Open Access
Clinical risk factors for Clostridium difficile-associated diseases
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Sung Min Cho, Jae Joon Lee, Hee Jung Yoon
Corresponding author
yhj822@medimail.co.kr

Corresponding author at: Division of Infectious Diseases, Department of Internal Medicine, Eulji University School of Medicine, 1306 Dunsandong, Seogu, Daejeon, 302-799, Korea.
Division of Infectious Diseases and Department of Internal Medicine, Eulji University Medical Center, Daejeon, Korea
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Abstract

Many factors appear to influence the chance of acquiring Clostridium difficile (C. difficile) infection, and an accurate identification of risk factors could be beneficial in many ways. Thus, in the present study, clinical risk factors for C. difficile-associated disease (CDAD) in Korea were identified. A total of 93 patients who met the inclusion criteria and 186 age/gender/ward/admission period-matched control patients were included in this study. Statistically significant associations were found with presence of chronic lung diseases (odds ratio [OR], 3.41; 95% confidence interval [CI], 1.25–9.32; p=0.017), presence of ileus (OR, 10.05; 95% CI, 2.42–41.80; p=0.001), presence of intensive care unit (ICU) stay (OR, 9.79; 95% CI, 3.03–31.68; p<0.001), use of cephalosphorins (OR, 3.30; 95% CI, 1.13–9.62; p=0.029), history of surgery (OR, 10.89; 95% CI, 3.96–29.92; p<0.001), and history of longterm care facility stay (OR, 14.90; 95% CI, 4.02–55.26; p<0.001). Awareness of CDAD is critical to provide appropriate clinical care. Surveillance of the national incidence rate and multicenter studies are needed, and the potential value of a C. difficile vaccine should be studied.

Keywords:
Risk factors
Clostridium difficile-associated diseases
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References
[1.]
S.L. Gorbach.
Antibiotics and Clostridium difficile.
N Engl J Med, 341 (1999), pp. 1690-1691
[2.]
R. Gaynes, D. Rimland, E. Killum, et al.
Outbreak of Clostridium difficile infection in a long-term care facility: association with gatifloxacin use.
Clin Infect Dis, 38 (2004), pp. 640-645
[3.]
M.E. McCusker, A.D. Harris, E. Perencevich, M.C. Roghmann.
Fluoroquinolone use and Clostridium difficile associated diarrhea.
Emerg Infect Dis, 9 (2003), pp. 730-733
[4.]
C.A. Muto, M. Pokrywka, K. Shutt, et al.
A large outbreak of Clostridium difficile–associated disease with an unexpected proportion of deaths and colectomies at a teaching hospital following increased fluoroquinolone use.
Infect Control Hosp Epidemiol, 26 (2005), pp. 273-280
[5.]
C.L. Golledge, C.F. Carson, G.L. O’Neill, R.A. Bowman, T.V. Riley.
Ciprofloxacin and Clostridium difficile-associated diarrhoea.
J Antimicrob Chemother, 30 (1992), pp. 141-147
[6.]
R. Alonso, T. Pelaez, M.J. Gonzalez-Abad, et al.
In vitroactivity of new quinolones against Clostridium difficile.
J Antimicrob Chemother, 47 (2001), pp. 195-197
[7.]
D.N. Gerding, S. Johnson, L.R. Peterson, M.E. Mulligan, J. Silva.
SHEA position paper: Clostridium difficile-associated diarrhea and colitis.
Infect Control Hosp Epidemiol, 16 (1995), pp. 459-477
[8.]
A. Anand, B. Bashey, T. Mir, A.E. Glatt.
Epidemiology, clinical manifestations, and outcome of Clostridium difficile-associated diarrhea.
Am J Gastroenterol, 89 (1994), pp. 519-523
[9.]
E.M. Jones, B.L. Kirkpatrick, R. Feeney, D.S. Reeves, A.P. MacGowan.
Hospital-acquired Clostridium difficile diarrhea.
Lancet, 349 (1997), pp. 1176-1177
[10.]
K.J. Walker, S.S. Gilliland, K. Vance-Bryan, et al.
Clostridium difficile colonization in residents of long-term care facilities: prevalence and risk factors.
J Am Geriatr Soc, 41 (1993), pp. 940-946
[11.]
A.E. Simor, S.F. Bradley, L.J. Strausbaugh, et al.
Clostridium difficile in long-term care facilities for the elderly.
Infect Control Hosp Epidemiol, 23 (2002), pp. 696-703
[12.]
D.Z. Bliss, S. Johnson, K. Savik, C.R. Clabots, K. Willard, D.N. Gerding.
Acquisition of Clostridium difficile and Clostridium difficile associated diarrhea in hospitalized patients receiving tube feeding.
Ann Int Med, 129 (1998), pp. 1012-1019
[13.]
L. Kyne, S. Sougioultzis, L.V. McFarland, C.P. Kelly.
Underlying disease severity as a major risk factor for nosocomial Clostridium difficile diarrhea.
Infect Control Hosp Epi, 23 (2002), pp. 653
[14.]
S.D. Horn, P.D. Sharkey, D.A. Bertram.
Measuring severity of illness: homogeneous case mix groups.
Med Care, 21 (1983), pp. 14-30
[15.]
K.W. Garey, S. Sethi, Y. Yadav, H.L. DuPont.
Meta-analysis to assess risk factors for recurrent Clostridium difficile infection.
Journal of Hospital Infection, 70 (2008), pp. 298-304
[16.]
T.V. Riley, M. Cooper, B. Bell, C.L. Golledge.
Community-acquired Clostridium difficile-associated diarrhea.
Clin Infect Dis, 20 (1995), pp. S263-S265
[17.]
J.H. Lee, S.Y. Lee, Y.S. Kim, et al.
The incidence and clinical features of Clostridium difficile infection; single center study.
J Korean Gastroenterol, 55 (2010), pp. 175-182
[18.]
S. Johnson.
Recurrent Clostridium difficile infection: a review of risk factors, treatments, and outcomes.
J Infection., 58 (2009), pp. 403-410
[19.]
M.F. Kurd, L. Pulido, A. Joshi, J.J. Purtill, J. Parvizi.
Clostridium difficile infection after total joint arthroplasty: who is at risk?.
J Arthroplasty, 23 (2008), pp. 839-842
[20.]
A.H. Bruns, J.J. Oosterheert, E.J. Kuijper, et al.
Impact of different empirical antibiotic treatment regimens for community-acquired pneumonia on the emergence of Clostridium difficile.
J Antimicrob Chemother, 65 (2010), pp. 2464-2471
[21.]
S.B. Debast, N. Vaessen, A. Choudry, E.A. Wiegers-Ligtvoet, R.J. van den Berg, E.J. Kuijper.
Successful combat of an outbreak due to Clostridium difficile PCR ribotype 027 and recognition of specific risk factors.
Clin Microbiol Infect, 15 (2009), pp. 427-434
[22.]
M.Y. Hu, S. Maroo, L. Kyne, et al.
A prospective study of risk factors and historical trends in metronidazole failure for Clostridium difficile infection.
Clin Gastroenterol Hepatol, 6 (2008), pp. 1354-1360
[23.]
T.J. Henrich, D. Krakower, A. Bitton, D.S. Yokoe.
Clinical risk factors for severe Clostridium difficile-associated disease.
Emerg Infect Dis, 15 (2009), pp. 415-422
[24.]
J. Bishara, N. Peled, S. Pitlik, Z. Samra.
Mortality of patients with antibiotic-associated diarrhoea: the impact of Clostridium difficile.
J Hosp Infect, 68 (2008), pp. 308-314
[25.]
J. Cloud, L. Noddin, A. Pressman, M. Hu, C. Kelly.
Clostridium difficile strain NAP-1 is not associated with severe disease in a nonepidemic setting.
Clin Gastroenterol Hepatol, 7 (2009), pp. 868-873
[26.]
S.R. Curry, J.W. Marsh, K.A. Shutt, et al.
High frequency of rifampin resistance identified in an epidemic Clostridium difficile clone from a large teaching hospital.
Clin Infect Dis, 48 (2009), pp. 425-429
[27.]
M. Miller.
The fascination with probiotics for Clostridium difficile infection: lack of evidence for prophylactic or therapeutic efficacy.
[28.]
J.I. Tokars, S. Satake, D. Rimland, et al.
The prevalence of colonization with vancomycin-resistant Enterococcus at a veterans’ affairs institution.
Infect Control Hosp Epidemiol, 20 (1999), pp. 171-175
[29.]
M.E. Rafferty, M.I. McCormick, L.H. Bopp, et al.
Vancomycinresistant enterococci in stool specimens submitted for Clostridium difficile cytotoxin assay.
Infect Control Hosp Epidemiol, 18 (1997), pp. 342-344
[30.]
A. Sonnenberg.
Similar geographic variations of mortality and hospitalization associated with IBD and Clostridium difficile colitis.
Inflamm Bowel Dis, 16 (2000), pp. 487-493
[31.]
R.J. Drew, B. Boyle.
RUWA scoring system: a novel predictive tool for the identification of patients at high risk for complications from Clostridium difficile infection.
J Hosp Infect, 71 (2009), pp. 93-94
[32.]
A. Bhangu, A. Czapran, S. Bhangu, D. Pillay.
Optimum timing of blood tests for monitoring patients with Clostridium difficile associated diarrhea.
J Investig Med, 58 (2010), pp. 621-624
[33.]
M.Y. Hu, K. Katchar, L. Kyne, et al.
Prospective derivation and validation of a clinical prediction rule for recurrent Clostridium difficile infection.
Gastroenterology, 136 (2009), pp. 1206-1214
[34.]
J.R. Howitt, J.W. Grace, M.G. Schaefer, C. Dolder, C. Cannella, R.S. Schaefer.
Clostridium difficile–positive stools: a retrospective identification of risk factors.
Am J Infect Control, 36 (2008), pp. 488-491
[35.]
J. Ryan, C. Murphy, C. Twomey, et al.
Asymptomatic carriage of Clostridium difficile in an Irish continuing care institution for the elderly: prevalence and characteristics.
Ir J Med Sci, 179 (2010), pp. 245-250
[36.]
B.Y. Lee, M.J. Popovich, Y. Tian, et al.
The potential value of Clostridium difficile vaccine: an economic computer simulation model.
Vaccine, 28 (2010), pp. 5245-5253
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