J Korean Med Sci.  2011 Oct;26(10):1258-1264. 10.3346/jkms.2011.26.10.1258.

Epidemiology and Clinical Characteristics of Clostridium difficile Infection in a Korean Tertiary Hospital

• Kim J
• Pai H
• Seo MR
• Kang JO

• KMID: 1785980
• DOI: http://doi.org/10.3346/jkms.2011.26.10.1258

Abstract

In order to investigate the incidence, clinical and microbiologic characteristics of Clostridium difficile infection (CDI) in Korea, a prospective observational study was performed. From September 2008 through January 2010, all patients whose stool was tested for toxin assay A&B and/or C. difficile culture were studied for clinical characteristics. Toxin types of the isolates from stool were tested. The mean incidence of CDI per 100,000 patient-days was 71.6 by month (range, 52.5-114.0), and the ratio of CDI to antibiotic-associated diarrhea was 0.23. Among 200 CDI patients, 37.5% (75/200) was severe CDI based on severity score. Clinical outcome of 189 CDI was as followed; 25.9% (49/189) improved without treatment, 84.3% (118/140) achieved clinical cure and attributed mortality was 0.7% (1/140) with the treatment. Recurrence rate was 21.4% (30/140) and cure without recurrence was 66.4% (93/140). The most common type of toxin was toxin A-positive/toxin B-positive strain (77.5%), toxin A-negative/toxin B-positive strains or binary toxin-producing strains comprised 15.4% or 7.1%, respectively. In conclusion, the incidence of CDI in Korea is a little higher than other reports during the non-epidemic setting. We expect that the change of epidemiology and clinical severity in CDI can be evaluated based on these results.

Keyword

Clostridium difficile Infection; Incidence; Clinical Characteristics; Toxin Type

MeSH Terms

Aged
Bacterial Proteins/analysis
Bacterial Toxins/analysis
Clostridium Infections/*epidemiology/physiopathology
Clostridium difficile/*isolation & purification/*pathogenicity
Diarrhea/epidemiology/microbiology
Enterocolitis, Pseudomembranous/*epidemiology/microbiology/pathology
Enterotoxins/analysis
Feces/microbiology
Female
Hospitals
Humans
Incidence
Male
Metronidazole/therapeutic use
Middle Aged
Prospective Studies
Recurrence
Republic of Korea/epidemiology
Treatment Outcome
Vancomycin/therapeutic use

Figure

• 

  Fig. 1 The number of AAD patients and CDI patients is shown by bars and the incidence of CDI patients per 100,000 patient days by line with italic number. AAD, antibiotic associated diarrhea; CDI, Clostridium difficile infection; Pt*d, patient-day.

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