Format

Send to

Choose Destination
Clin Infect Dis. 2015 Dec 15;61(12):1781-8. doi: 10.1093/cid/civ749. Epub 2015 Sep 3.

Factors Associated With Complications of Clostridium difficile Infection in a Multicenter Prospective Cohort.

Author information

1
Department of Microbiology and Infectious Diseases, Université de Sherbrooke, Quebec.
2
Mount Sinai Hospital, Toronto, Ontario.
3
Hôpital Maisonneuve-Rosemont, Montréal, Quebec.
4
Sunnybrook Health Sciences Centre.
5
Toronto General Hospital.
6
St. Michael's Hospital.
7
Toronto East General Hospital.
8
North York General Hospital.
9
Leslie Dan Faculty of Pharmacy, University of Toronto, Ontario, Canada.

Abstract

BACKGROUND:

Clostridium difficile infection (CDI) is the most common cause of nosocomial infectious diarrhea and may result in severe complications including death. We conducted a prospective study to identify risk factors for complications of CDI (cCDI).

METHODS:

Adult inpatients with confirmed CDI in 10 Canadian hospitals were enrolled and followed for 90 days. Potential risk factors were measured within 24 hours of diagnosis. Isolates were typed by polymerase chain reaction ribotyping. cCDI was defined as 1 or more of the following: colonic perforation, toxic megacolon, colectomy, admission to an intensive care unit for cCDI, or if CDI contributed to death within 30 days of enrollment. Risk factors for cCDI were investigated by logistic regression.

RESULTS:

A total of 1380 patients were enrolled. cCDI was observed in 8% of patients. The ribotype was identified in 922 patients, of whom 52% were infected with R027. Age ≥ 80 years, heart rate >90/minute, respiratory rate >20/minute, white cell count <4 × 10(9)/L or ≥ 20 × 10(9)/L, albumin <25 g/L, blood urea nitrogen >7 mmol/L, and C-reactive protein ≥ 150 mg/L were independently associated with cCDI. A higher frequency of cCDI was observed among R027-infected patients (10.9% vs 7.2%), but the association was not significant in adjusted analysis.

CONCLUSIONS:

CDI complications were associated with older age, abnormal blood tests, and abnormal vital signs. These factors, which are readily available to clinicians at the time of diagnosis, could be used for outcome prediction and risk stratification to select patients who may need closer monitoring or more aggressive therapy.

KEYWORDS:

Clostridium difficile; complications; mortality; ribotype 027; risk factors

PMID:
26338788
PMCID:
PMC4657538
DOI:
10.1093/cid/civ749
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Silverchair Information Systems Icon for PubMed Central
Loading ...
Support Center