Infect Chemother.  2007 Apr;39(2):71-77.

Prognosis Factors of Clostridium difficile Associated Diarrhea

Affiliations
  • 1Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. jmkim@yumc.yonsei.ac.kr
  • 2Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea.
  • 3Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, Korea.
  • 4AIDS Research Institute Yonsei University College of Medicine, Seoul, Korea.

Abstract

BACKGROUND: Clostridium difficile associated diarrhea (CDAD) has a wide range of clinical manifestations. The prognostic factors of CDAD are not fully understood.
MATERIALS AND METHODS
A retrospective cohort study of 115 patients with CDAD from Aug. 2002 to Dec. 2003 was conducted to evaluate prognostic factors of CDAD. Bacteriologic factors were determined by detecting the binary toxin gene, tcd A, tcd A rep and tcd B gene. Poor prognosis was defined as diarrhea more than 10 days even with classic treatment, recurrence, death, and moribund discharge.
RESULTS
Approximately 79% of isolated strains were toxin A+/B+ strains and 21% were toxin A-/B+ strains. There was no difference in prognosis between toxin A+ and toxin A- strains. 39 (33.9%) cases showed poor prognosis and 76 (66.1%) cases showed good prognosis. Univariate analyses revealed that the poor prognostic factors were old age over 70 years old, male, the number of antibiotics used after onset of symptom, the administration of carbapenems, aminoglycosides, glycopeptides after onset of symptom, history of DM and stroke, and high Charlson comorbidity index. Multiple logistic regression analysis identified old age over 70 years old (odds ratio=3.378, P=0.009) and the administration of carbapenems after onset of symptom (odds ratio 7.210, P< 0.001) as the independent poor prognostic factors.
CONCLUSION
Old age over 70 and the administration of carbapenems after onset of symptom were the poor prognostic factors for CDAD caused by none-binary toxin producing strains.

Keyword

Clostridium difficile; Clostridium difficile associated diarrhea; Prognosis factors; Diarrhea

MeSH Terms

Aged
Aminoglycosides
Anti-Bacterial Agents
Carbapenems
Clostridium difficile*
Clostridium*
Cohort Studies
Comorbidity
Diarrhea*
Glycopeptides
Humans
Logistic Models
Male
Prognosis*
Recurrence
Retrospective Studies
Stroke
Aminoglycosides
Anti-Bacterial Agents
Carbapenems
Glycopeptides
Full Text Links
  • IC
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr