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Long-Term Clinical Outcome of Clostridium difficile Infection in Hospitalized Patients: A Single Center Study.

Doh YS, Kim YS, Jung HJ, Park YI, Mo JW, Sung H, Lee KJ, Seo YK, Moon JS, Hong SW - Intest Res (2014)

Bottom Line: We therefore investigated the long-term clinical outcomes of patients with CDI, including delayed recurrence, associated risk factors and mortality.Delayed recurrence was observed in 17 patients (19.5%), and significant risk factors were age (over 70 years, P=0.049), nasogastric tube insertion (P=0.008), and proton pump inhibitor or H2-blocker treatments (P=0.028).Although CDI-related mortality was not reported, 2-year (32.5%) mortality rate of CDI patients implies that a CDI diagnosis may predict severe morbidity and poor prognosis of the underlying disease.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea.

ABSTRACT

Background/aims: Antibiotic usage and increasingly aging populations have led to increased incidence of Clostridium difficile infection (CDI) in worldwide. Recent studies in Korea have also reported increasing CDI incidence; however, there have been no reports on the long-term outcomes of CDI. We therefore investigated the long-term clinical outcomes of patients with CDI, including delayed recurrence, associated risk factors and mortality.

Methods: Hospitalized patients diagnosed with CDI at Seoul Paik Hospital between January 2007 and December 2008 were included. Their medical records were retrospectively investigated. 'Delayed recurrence' was defined as a relapse 8 weeks after a successful initial treatment. Multivariate logistic regression analysis was performed to identify risk factors for the delayed recurrence. Kaplan-Meier curves were used to analyze mortality rates.

Results: A total of 120 patients were enrolled; among them, 87 were followed-up for at least 1 year, with a mean follow-up period of 34.1±25.1 months. Delayed recurrence was observed in 17 patients (19.5%), and significant risk factors were age (over 70 years, P=0.049), nasogastric tube insertion (P=0.008), and proton pump inhibitor or H2-blocker treatments (P=0.028). The 12- and 24-month mortality rates were 24.6% and 32.5%, respectively. No deaths were directly attributed to CDI.

Conclusions: Delayed recurrence of CDI was not rare, occurring in 19.5% of the study population. Although CDI-related mortality was not reported, 2-year (32.5%) mortality rate of CDI patients implies that a CDI diagnosis may predict severe morbidity and poor prognosis of the underlying disease.

No MeSH data available.


Related in: MedlinePlus

Kaplan-Meier curve of delayed recurrence in patients with Clostridium difficile infection.
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Figure 1: Kaplan-Meier curve of delayed recurrence in patients with Clostridium difficile infection.

Mentions: Among 87 patients available for survival/death and clinical follow-up 1 year after CDI diagnosis, there were 17 cases (19.5%) of delayed recurrence 8 weeks after successful treatment. Kaplan-Meier curve analysis showed a recurrence rate of 31% after 60 months (Fig. 1). In particular, of 19 early recurrence cases, 8 re-occurred after 8 weeks, a recurrence rate 42.1% among patients with early recurrence, a finding comparable to previous reports.20,21,24


Long-Term Clinical Outcome of Clostridium difficile Infection in Hospitalized Patients: A Single Center Study.

Doh YS, Kim YS, Jung HJ, Park YI, Mo JW, Sung H, Lee KJ, Seo YK, Moon JS, Hong SW - Intest Res (2014)

Kaplan-Meier curve of delayed recurrence in patients with Clostridium difficile infection.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4214957&req=5

Figure 1: Kaplan-Meier curve of delayed recurrence in patients with Clostridium difficile infection.
Mentions: Among 87 patients available for survival/death and clinical follow-up 1 year after CDI diagnosis, there were 17 cases (19.5%) of delayed recurrence 8 weeks after successful treatment. Kaplan-Meier curve analysis showed a recurrence rate of 31% after 60 months (Fig. 1). In particular, of 19 early recurrence cases, 8 re-occurred after 8 weeks, a recurrence rate 42.1% among patients with early recurrence, a finding comparable to previous reports.20,21,24

Bottom Line: We therefore investigated the long-term clinical outcomes of patients with CDI, including delayed recurrence, associated risk factors and mortality.Delayed recurrence was observed in 17 patients (19.5%), and significant risk factors were age (over 70 years, P=0.049), nasogastric tube insertion (P=0.008), and proton pump inhibitor or H2-blocker treatments (P=0.028).Although CDI-related mortality was not reported, 2-year (32.5%) mortality rate of CDI patients implies that a CDI diagnosis may predict severe morbidity and poor prognosis of the underlying disease.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea.

ABSTRACT

Background/aims: Antibiotic usage and increasingly aging populations have led to increased incidence of Clostridium difficile infection (CDI) in worldwide. Recent studies in Korea have also reported increasing CDI incidence; however, there have been no reports on the long-term outcomes of CDI. We therefore investigated the long-term clinical outcomes of patients with CDI, including delayed recurrence, associated risk factors and mortality.

Methods: Hospitalized patients diagnosed with CDI at Seoul Paik Hospital between January 2007 and December 2008 were included. Their medical records were retrospectively investigated. 'Delayed recurrence' was defined as a relapse 8 weeks after a successful initial treatment. Multivariate logistic regression analysis was performed to identify risk factors for the delayed recurrence. Kaplan-Meier curves were used to analyze mortality rates.

Results: A total of 120 patients were enrolled; among them, 87 were followed-up for at least 1 year, with a mean follow-up period of 34.1±25.1 months. Delayed recurrence was observed in 17 patients (19.5%), and significant risk factors were age (over 70 years, P=0.049), nasogastric tube insertion (P=0.008), and proton pump inhibitor or H2-blocker treatments (P=0.028). The 12- and 24-month mortality rates were 24.6% and 32.5%, respectively. No deaths were directly attributed to CDI.

Conclusions: Delayed recurrence of CDI was not rare, occurring in 19.5% of the study population. Although CDI-related mortality was not reported, 2-year (32.5%) mortality rate of CDI patients implies that a CDI diagnosis may predict severe morbidity and poor prognosis of the underlying disease.

No MeSH data available.


Related in: MedlinePlus