title: A multicenter study of Clostridium difficile infection-related colectomy, 2000-2006.
abstract: OBJECTIVE
  To assess Clostridium difficile infection (CDI)-related colectomy rates by CDI surveillance definitions and over time at multiple healthcare facilities.
  
  
  METHODS
  Five university-affiliated acute care hospitals in the United States.
  
  
  METHODS
  Cases of CDI and patients who underwent colectomy from July 2000 through June 2006 were identified from 5 US tertiary care centers. Monthly CDI-related colectomy rates were calculated as the number of CDI-related colectomies per 1,000 CDI cases, and cases were categorized according to recommended surveillance definitions. Logistic regression was performed to evaluate risk factors for CDI-related colectomy.
  
  
  RESULTS
  In total, 8,569 cases of CDI were identified, and 75 patients underwent CDI-related colectomy. The overall colectomy rate was 8.7 per 1,000 CDI cases. The CDI-related colectomy rate ranged from 0 to 23 per 1,000 CDI episodes across hospitals. The colectomy rate for healthcare-facility-onset CDI was 4.3 per 1,000 CDI cases, and that for community-onset CDI was 16.5 per 1,000 CDI cases (P < .05). There were significantly more CDI-related colectomies at hospitals B and C (P < .05).
  
  
  CONCLUSIONS
  The overall CDI-related colectomy rate was low, and there was no significant change in the CDI-related colectomy rate over time. Onset of disease outside the study hospital was an independent risk factor for colectomy.
authors.affiliation: Washington University School of Medicine, St. Louis, Missouri, USA.
authors.forename: Amelia M
authors.initials: AM
authors.lastname: Kasper
authors.forename: Humaa A
authors.initials: HA
authors.lastname: Nyazee
authors.forename: Deborah S
authors.initials: DS
authors.lastname: Yokoe
authors.forename: Jeanmarie
authors.initials: J
authors.lastname: Mayer
authors.forename: Julie E
authors.initials: JE
authors.lastname: Mangino
authors.forename: Yosef M
authors.initials: YM
authors.lastname: Khan
authors.forename: Bala
authors.initials: B
authors.lastname: Hota
authors.forename: Victoria J
authors.initials: VJ
authors.lastname: Fraser
authors.forename: Erik R
authors.initials: ER
authors.lastname: Dubberke
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016360:Clostridioides difficile / Q000302:isolation & purification*; D003015:Clostridium Infections / Q000453:epidemiology / Q000209:etiology*; D003082:Colectomy / Q000009:adverse effects*; D003428:Cross Infection; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014481:United States / Q000453:epidemiology; D055815:Young Adult