1. Emergence of community-acquired Clostridium difficile infection: the experience of a French hospital and review of the literature.
- Author
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Ogielska M, Lanotte P, Le Brun C, Valentin AS, Garot D, Tellier AC, Halimi JM, Colombat P, Guilleminault L, Lioger B, Vegas H, De Toffol B, Constans T, and Bernard L
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Clostridioides difficile immunology, Clostridium Infections mortality, Community-Acquired Infections mortality, Cross Infection mortality, Diarrhea epidemiology, Diarrhea virology, Female, France epidemiology, Hospitals, University, Humans, Long-Term Care, Male, Middle Aged, Prospective Studies, Retrospective Studies, Risk Factors, Young Adult, Clostridioides difficile isolation & purification, Clostridium Infections embryology, Community-Acquired Infections epidemiology, Cross Infection epidemiology
- Abstract
Background: Clostridium difficile infection (CDI) is a common cause of nosocomial diarrhoea. People in the general community are not usually considered to be at risk of CDI. CDI is associated with a high risk of morbidity and mortality. The risk of severity is defined by the Clostridium Severity Index (CSI)., Methods: The cases of 136 adult patients with CDI treated at the University Hospital of Tours, France between 2008 and 2012 are described. This was a retrospective study., Results: Among the 136 patients included, 62 were men and 74 were women. Their median age was 64.4 years (range 18-97 years). Twenty-six of the 136 (19%) cases were community-acquired (CA) and 110 (81%) were healthcare-acquired (HCA). The major risk factors for both groups were long-term treatment with proton pump inhibitors (54% of CA, 53% of HCA patients) and antibiotic treatment within the 2.5 months preceding the CDI (50% of CA, 91% of HCA). The CSI was higher in the CA-CDI group (1.56) than in the HCA-CDI group (1.39). Intensive care was required for 8% of CA-CDI and 16.5% of HCA-CDI patients., Conclusions: CDI can cause community-acquired diarrhoea, and CA-CDI may be more severe than HCA-CDI. Prospective studies of CDI involving people from the general community without risk factors are required to confirm this observation., (Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.)
- Published
- 2015
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