title: Clinical manifestations of Clostridium difficile infection in a medical center in Taiwan.
abstract: OBJECTIVE
  To investigate the clinical characteristics of Clostridium difficile infection (CDI) at a medical center in Taiwan.
  
  
  METHODS
  Patients with CDI were identified from medical records at the National Taiwan University Hospital (Taipei, Taiwan). The following information was gathered and analyzed to better understand the clinical manifestations of CDI: age; sex; underlying immunocompromised conditions; laboratory data; in-hospital mortality; and previous use of drugs such as antimicrobial agents, steroids, and antipeptic ulcer agents.
  
  
  RESULTS
  During the years 2000-2010, 122 patients were identified as having CDI. This included 92 patients with nontoxigenic CDI (i.e., positive stool culture for C. difficile but negative results for toxins A and B) and 30 patients with toxigenic CDI (i.e., positive stool culture cultures for C. difficile and positive results for toxins A and B). Of the 122 patients, 48 (39%) patients were older than 65 years and most patients acquired the CDI while in the hospital. Active cancer was the most common reason for hospitalization, followed by diabetes mellitus, and end-stage renal disease. More than 90% of the patients had received antibiotics before acquiring CDI. The results of fecal leukocyte examinations were positive in 33 (27%) patients. The overall in-hospital mortality rate was 26.2%. There were no significant differences between patients with nontoxigenic CDI and patients with toxigenic CDI.
  
  
  CONCLUSIONS
  Clostridium difficile infection can develop in healthcare facilities and in community settings, especially in immunocompromised patients.
authors: Department of Intensive Care Medicine, Chi Mei Medical Center, Liouying, Tainan, Taiwan.
authors: Chih-Cheng
authors: CC
authors: Lai
authors: Department of Respiratory Therapy, Fu Jen Catholic University, New Taipei City, Taiwan; Department of Internal Medicine, New Taipei City Hospital, New Taipei City, Taiwan.
authors: Sheng-Hsiang
authors: SH
authors: Lin
authors: Department of Intensive Care Medicine, Tainan, Taiwan.
authors: Che-Kim
authors: CK
authors: Tan
authors: Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
authors: Chun-Hsing
authors: CH
authors: Liao
authors: Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
authors: Yu-Tsung
authors: YT
authors: Huang
authors: Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan; Department Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan. Electronic address: hsporen@ntu.edu.tw.
authors: Po-Ren
authors: PR
authors: Hsueh
mesh_terms: D000046:Academic Medical Centers; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D016360:Clostridioides difficile / Q000302:isolation & purification*; D003015:Clostridium Infections / Q000453:epidemiology* / Q000382:microbiology* / Q000401:mortality / Q000473:pathology; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology* / Q000401:mortality / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013624:Taiwan; D055815:Young Adult
keywords: Clostridium difficile; Epidemiology; Infection; Taiwan