Clinical characteristics of Clostridium difficile-associated diarrhea among patients in a tertiary care center in China

Abstract

Objective: This study investigated the incidence, risk factors, and clinical characteristics of Clostridium difficile-associated diarrhea (CDAD) in Chinese patients.

Methods: Fecal specimens of patients with antibiotic-associated diarrhea (AAD) were collected to test C. difficile toxin A and B using enzyme-linked fluorescent assay to identify CDAD. By adopting a nested case-control design, the matched people (ratio 1:3) without AAD were included as controls.

Results: Out of 56,172 inpatients, 39,882 (71.0%) used antibiotics, 470 suffered from AAD, and 93 were diagnosed with CDAD. The incidence of nosocomial CDAD was 166 per 100,000. The proportion of CDAD in AAD was 19.8%. CDAD patients presented with more severe clinical manifestations and exhibited more concurrent illness. Logistic regression analysis showed the risk factors of CDAD: advanced age, nasogastric tube-feeding, high APACHE II scores, high level of serum C-reaction protein, low level of serum albumin, severe underlining disease or comorbidity, and number of antibiotic intake. Twenty-nine patients (31.2%) were cured with vancomycin, 54 (58.1%) were cured after dual therapy of vancomycin plus metronidazole, 7 (7.5%) died of underlying diseases aggravated with CDAD, and 3 (3.2%) were transferred to other hospitals for personal reasons.

Conclusion: The incidence of nosocomial CDAD in China was high. Some risk factors could predispose CDAD.

doi: http://dx.doi.org/10.12669/pjms.323.9400

How to cite this:Li Y, Huang Y, Li Y, Nie Y. Clinical characteristics of Clostridium difficile-associated diarrhea among patients in a tertiary care center in China. Pak J Med Sci. 2016;32(3):736-741.   doi: http://dx.doi.org/10.12669/pjms.323.9400

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