J Korean Surg Soc.  2012 Jul;83(1):14-20. 10.4174/jkss.2012.83.1.14.

Risk factors for the development of Clostridium difficile colitis in a surgical ward

• Kim MJ
• Kim BS
• Kwon JW
• Ahn SE
• Lee SS
• Park HC
• Lee BH

• KMID: 2212274
• DOI: http://doi.org/10.4174/jkss.2012.83.1.14

Abstract

PURPOSE
Clostridium difficile colitis (CDC) is a nosocomial infection. We attempted to discover the risk factors for the development of CDC in patients admitted to our surgical ward.
METHODS
We conducted a retrospective chart review of all patients admitted to our surgical ward between January 2010 and July 2011. CDC was confirmed when toxin A/B or toxin B polymerase chain reaction was detected in the stool and clinical symptoms, such as diarrhea, were present. We divided patients into the CDC and non-CDC groups, and compared the clinical features between the two groups.
RESULTS
The rate of CDC occurrence was 0.4% (19/4,720 patients). Univariate analysis showed that colectomy (P < 0.001), hospital stays longer than 10 days (P < 0.001), aged over 55 years (P < 0.001) and transfer from medical ward (P = 0.009) were significant parameters for CDC. Multivariate analysis showed that colectomy (P < 0.001; odds ratio [OR], 8.405; 95% confidence interval [CI], 2.927 to 24.132) and hospital stays longer than 10 days (P = 0.035; OR, 10.253; 95% CI, 1.176 to 89.392) were high risk factors for CDC occurrence in the surgical ward.
CONCLUSION
The risk factors for CDC in a surgical ward could be colectomy and a long duration of hospitalization. Therefore, clinicians should consider the possibility of CDC when patients undergo colectomy, are admitted for a long time, and have postoperative diarrhea.

Keyword

Clostridium difficile; Colitis; Risk factors; Colectomy

MeSH Terms

Aged
Centers for Disease Control and Prevention (U.S.)
Clostridium
Clostridium difficile
Colectomy
Colitis
Cross Infection
Diarrhea
Hospitalization
Humans
Length of Stay
Multivariate Analysis
Odds Ratio
Polymerase Chain Reaction
Retrospective Studies
Risk Factors

Figure

• 

  Fig. 1 This figure shows the control chart of Clostridium difficile colitis rate per patient. SD, standard deviation.

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