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KMID : 0988920140120040299
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Intestinal Research
2014 Volume.12 No. 4 p.299 ~ p.305
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Long-Term Clinical Outcome of Clostridium difficile Infection in Hospitalized Patients: A Single Center Study
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Doh Young-Seok
Kim You-Sun
Jung Hye-Jin
Park Young-Il
Mo Jin-Won
Sung Hyun
Lee Kyung-Jin
Seo Young-Ki
Moon Jeong-Seop
Hong Seong-Woo
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Abstract
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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. (Intest Res 2014;12:299-305)
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KEYWORD
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Clostridium difficile, Recurrence, Mortality, Risk factors
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