title: Risk factors for recurrence of Clostridium difficile infection: effect of vancomycin-resistant enterococci colonization.
abstract: Recurrent Clostridium difficile infection (CDI) is one of the most difficult problems in healthcare infection control. We evaluated the risk factors associated with recurrence in patients with CDI. A retrospective cohort study of 84 patients with CDI from December 2008 through October 2010 was performed at Pusan National University Yangsan Hospital. Recurrence occurred in 13.1% (11/84) of the cases and in-hospital mortality rate was 7.1% (6/84). Stool colonization with vancomycin-resistant enterococci (VRE) (P = 0.006), exposure to more than 3 antibiotics (P = 0.009), low hemoglobin levels (P = 0.025) and continued use of previous antibiotics (P = 0.05) were found to be more frequent in the recurrent group. Multivariate analysis indicated that, stool VRE colonization was independently associated with CDI recurrence (odds ratio, 14.519; 95% confidence interval, 1.157-182.229; P = 0.038). This result suggests that stool VRE colonization is a significant risk factor for CDI recurrence.
authors: Department of Internal Medicine, Division of Infections Disease, Medical Research Institute, Pusan National University School of Medicine, Busan, Korea.
authors: Hee Kyoung
authors: HK
authors: Choi
authors: Kye Hyung
authors: KH
authors: Kim
authors: Sun Hee
authors: SH
authors: Lee
authors: Su Jin
authors: SJ
authors: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016360:Clostridioides difficile; D015331:Cohort Studies; D016983:Enterococcus / Q000302:isolation & purification*; D004761:Enterocolitis, Pseudomembranous / Q000188:drug therapy / Q000209:etiology* / Q000401:mortality; D005243:Feces / Q000382:microbiology; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D017052:Hospital Mortality; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D014640:Vancomycin / Q000627:therapeutic use*; D020713:Vancomycin Resistance
chemical_list: D000900:Anti-Bacterial Agents; D006454:Hemoglobins; D014640:Vancomycin