Intest Res.  2012 Apr;10(2):176-182. 10.5217/ir.2012.10.2.176.

Risk Factors for Recurrent Clostridium difficile Infection

• Ryu HS
• Kim YS
• Seo GS
• Lee YM
• Choi SC

• KMID: 2174239
• DOI: http://doi.org/10.5217/ir.2012.10.2.176

Abstract

BACKGROUND/AIMS
Clostridium difficile infection (CDI) is a common nosocomial infection associated with substantial morbidity, mortality and increased medical care costs. Although most patients initially respond to therapy, with either metronidazole or vancomycin, about 15-20% of patients experience recurrence. The aim of this study was to analyze the risk factors related to recurrent CDI (RCDI).
METHODS
We retrospectively reviewed data, from patients diagnosed with CDI during admission at a university hospital between January 2000 and December 2006, for comparison with data from RCDI patients.
RESULTS
Among a total of 294 CDI patients, 32 (10.8%) had experienced RCDI. Risk factors for RCDI included anemia, congestive heart failure, respiratory infection, time between admission and CDI diagnosis, duration of antibiotic therapy prior to CDI diagnosis, tube feeding, and gastrointestinal endoscopy. Multivariate analysis revealed that tube feeding was associated with recurrence (odds ratio, 3.65; 95% confidence interval, 1.38-9.65; P=0.009).
CONCLUSIONS
Patients who received tube feeding were at increased risk of RCDI. Targeting these patients for preventive strategies may contribute to a reduction in the incidence of RCDI.

Keyword

Clostridium difficile; Recurrence; Risk Factors; Enteral Nutrition

MeSH Terms

Anemia
Clostridium
Clostridium difficile
Cross Infection
Endoscopy, Gastrointestinal
Enteral Nutrition
Health Care Costs
Heart Failure
Humans
Incidence
Metronidazole
Multivariate Analysis
Recurrence
Retrospective Studies
Risk Factors
Vancomycin
Metronidazole
Vancomycin