J Korean Med Sci.  2011 Jul;26(7):859-864. 10.3346/jkms.2011.26.7.859.

Risk Factors for Recurrence of Clostridium difficile Infection: Effect of Vancomycin-resistant Enterococci Colonization

Affiliations
  • 1Department of Internal Medicine, Division of Infections Disease, Medical Research Institute, Pusan National University School of Medicine, Busan, Korea. beauty192@hanmail.net

Abstract

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.

Keyword

Clostridium difficile; Recurrence; Risk factors; VRE

MeSH Terms

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

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