Back to Search
Start Over
Community-onset Clostridium difficile infection at a tertiary medical center in southern Taiwan, 2007–2015
- Source :
- Journal of Microbiology, Immunology and Infection, Vol 51, Iss 2, Pp 243-250 (2018)
- Publication Year :
- 2018
- Publisher :
- Elsevier, 2018.
-
Abstract
- Background: Clostridium difficile infection (CDI) is well-known as the major cause of infectious diarrhea in hospitalized patients. Community-onset CDI (CO-CDI) is an emerging threat. However, clinical information of CO-CDI in Taiwan remains scarce. Methods: A retrospective study was conducted at a medical center in southern Taiwan. Symptomatic patients between 2007 and 2015 with C. difficile toxin or tcdB detected in stool were identified as CDI, and were classified as CO-CDI [including community-associated CDI (CA-CDI) and community-onset health care facility-associated CDI (CO-HCFA-CDI)] and health care facility-onset CDI (HCFO-CDI). Results: Of 427 patients, 15 (3.5%) were CA-CDI, 49 (11.5%) CO-HCFA-CDI, and 363 (85.0%) HCFO-CDI. Despite major involvement of the elderly (mean age: 66.1 years vs. 69.9 years, p = 0.46), no significant differences were noted between CA-CDI and CO-HCFA-CDI groups, except that solid organ cancer was more common in the CO-HCFA-CDI group. The CO-CDI group more often presented with abdominal pain but had shorter hospital stays and less exposure of proton-pump inhibitors or broad-spectrum antibiotics than the HCFO-CDI group did. The mortality rate related to CDI was 4.7% (3 patients) in the CO-CDI group. Despite a lower in-hospital mortality rate in the CO-CDI group (10.9% vs. 22.0%; p = 0.04), the recurrence rate was similar (10.9% vs. 7.2%; p = 0.3). Conclusions: CO-CDI is not common but associated with substantial morbidity and mortality. Physicians should put CDI into consideration among patients who present community-onset fever, diarrhea, or abdominal pain alone or in combination. Keywords: Clostridium difficile infection, community onset, diarrhea, Taiwan
- Subjects :
- Microbiology
QR1-502
Subjects
Details
- Language :
- English
- ISSN :
- 16841182
- Volume :
- 51
- Issue :
- 2
- Database :
- Directory of Open Access Journals
- Journal :
- Journal of Microbiology, Immunology and Infection
- Publication Type :
- Academic Journal
- Accession number :
- edsdoj.40be2a09b2e44d18face8e7fc6c0c3d
- Document Type :
- article
- Full Text :
- https://doi.org/10.1016/j.jmii.2016.08.013