[Clostridium difficile infections at Landspítali - 1998-2008].
To study the epidemiology and severity of C. difficile infections (CDI) at Landspítali over 11 year period, 1998-2008.



CDI were identified by a positive toxin assay in stools from the database of the Department of Microbiology. Chart review was conducted on patients diagnosed in January and June each year during the study period, a total of 237 infections.



Overall, 1,861 of 11,968 submitted stool samples were positive for C. difficile toxin, representing 1,492 infections. The population-based incidence was 29% higher in the end than in the beginning of the period and was highest in the age group >80 years where it was 387 cases per 100,000 person-years. The incidence per 1,000 admissions and 10,000 hospital days increased by 71% and 102%, respectively. 47% of the infections were nosocomial. Most patients had history of antibiotic exposure prior to the infection and the most common symptom was diarrhea. Response to a single antibiotics course was good (93%). No patient required surgery due to colitis.



The incidence of CDI was higher in 2008 than 11 years before. Most patients had well characterized risk factors for CDI. For most patients a single course of metronidazole treatment resolved the infection. Based on these data, the severity of CDI does not seem to be increasing in Iceland.
Kvaran
Rúnar Bragi
RB
elsava@landspitali.is
Valsdóttir
Elsa Björk
EB
Sigurdsson
Helgi Kjartan
HK
Gottfredsson
Magnús
M
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016360:Clostridioides difficile / Q000302:isolation & purification*; D003015:Clostridium Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D005243:Feces / Q000382:microbiology; D006760:Hospitalization; D006761:Hospitals; D006801:Humans; D007055:Iceland / Q000453:epidemiology; D015994:Incidence; D008795:Metronidazole / Q000627:therapeutic use; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D008795:Metronidazole