title: Hematologic diseases: high risk of Clostridium difficile associated diarrhea.
abstract: OBJECTIVE
  To investigate the incidence and clinical outcome of Clostridium difficile (C. difficile) associated diarrhea (CDAD) in patients with hematologic disease.
  
  
  METHODS
  We retrospectively reviewed the medical records of patients who underwent C. difficile testing in a tertiary hospital in 2011. The incidence and risk factors for CDAD and its clinical course including recurrence and mortality were assessed in patients with hematologic disease and compared with those in patients with nonhematologic disease.
  
  
  RESULTS
  About 320 patients were diagnosed with CDAD (144 patients with hematologic disease; 176 with nonhematologic disease). The incidence of CDAD in patients with hematologic disease was estimated to be 36.7 cases/10000 patient hospital days, which was higher than the 5.4 cases/10000 patient hospital days in patients with nonhematologic disease. Recurrence of CDAD was more frequent in patients with hematologic disease compared to those with nonhematologic disease (18.8% vs 8.5%, P < 0.01), which was associated with higher re-use of causative antibiotics for CDAD. Mortality due to CDAD did not differ between the two groups. Multivariate analysis showed that intravenous immunoglobulin was the only significant factor associated with a lower rate of recurrence of CDAD in patients with hematologic disease.
  
  
  CONCLUSIONS
  The incidence and recurrence of CDAD was higher in patients with hematologic disease than in those with nonhematologic disease.
authors.affiliation: Tae-Geun Gweon, Myung-Gyu Choi, Myong Ki Baeg, Chul-Hyun Lim, Jae Myung Park, In Seok Lee, Sang Woo Kim, Division of Gastroenterology, Department of Internal Medicine, Seoul St Mary's hospital, The Catholic University of Korea, College of Medicine, Seoul 137-701, South Korea.
authors.forename: Tae-Geun
authors.initials: TG
authors.lastname: Gweon
authors.affiliation: Tae-Geun Gweon, Myung-Gyu Choi, Myong Ki Baeg, Chul-Hyun Lim, Jae Myung Park, In Seok Lee, Sang Woo Kim, Division of Gastroenterology, Department of Internal Medicine, Seoul St Mary's hospital, The Catholic University of Korea, College of Medicine, Seoul 137-701, South Korea.
authors.forename: Myung-Gyu
authors.initials: MG
authors.lastname: Choi
authors.affiliation: Tae-Geun Gweon, Myung-Gyu Choi, Myong Ki Baeg, Chul-Hyun Lim, Jae Myung Park, In Seok Lee, Sang Woo Kim, Division of Gastroenterology, Department of Internal Medicine, Seoul St Mary's hospital, The Catholic University of Korea, College of Medicine, Seoul 137-701, South Korea.
authors.forename: Myong Ki
authors.initials: MK
authors.lastname: Baeg
authors.affiliation: Tae-Geun Gweon, Myung-Gyu Choi, Myong Ki Baeg, Chul-Hyun Lim, Jae Myung Park, In Seok Lee, Sang Woo Kim, Division of Gastroenterology, Department of Internal Medicine, Seoul St Mary's hospital, The Catholic University of Korea, College of Medicine, Seoul 137-701, South Korea.
authors.forename: Chul-Hyun
authors.initials: CH
authors.lastname: Lim
authors.affiliation: Tae-Geun Gweon, Myung-Gyu Choi, Myong Ki Baeg, Chul-Hyun Lim, Jae Myung Park, In Seok Lee, Sang Woo Kim, Division of Gastroenterology, Department of Internal Medicine, Seoul St Mary's hospital, The Catholic University of Korea, College of Medicine, Seoul 137-701, South Korea.
authors.forename: Jae Myung
authors.initials: JM
authors.lastname: Park
authors.affiliation: Tae-Geun Gweon, Myung-Gyu Choi, Myong Ki Baeg, Chul-Hyun Lim, Jae Myung Park, In Seok Lee, Sang Woo Kim, Division of Gastroenterology, Department of Internal Medicine, Seoul St Mary's hospital, The Catholic University of Korea, College of Medicine, Seoul 137-701, South Korea.
authors.forename: In Seok
authors.initials: IS
authors.lastname: Lee
authors.affiliation: Tae-Geun Gweon, Myung-Gyu Choi, Myong Ki Baeg, Chul-Hyun Lim, Jae Myung Park, In Seok Lee, Sang Woo Kim, Division of Gastroenterology, Department of Internal Medicine, Seoul St Mary's hospital, The Catholic University of Korea, College of Medicine, Seoul 137-701, South Korea.
authors.forename: Sang Woo
authors.initials: SW
authors.lastname: Kim
authors.affiliation: Tae-Geun Gweon, Myung-Gyu Choi, Myong Ki Baeg, Chul-Hyun Lim, Jae Myung Park, In Seok Lee, Sang Woo Kim, Division of Gastroenterology, Department of Internal Medicine, Seoul St Mary's hospital, The Catholic University of Korea, College of Medicine, Seoul 137-701, South Korea.
authors.forename: Dong-Gun
authors.initials: DG
authors.lastname: Lee
authors.affiliation: Tae-Geun Gweon, Myung-Gyu Choi, Myong Ki Baeg, Chul-Hyun Lim, Jae Myung Park, In Seok Lee, Sang Woo Kim, Division of Gastroenterology, Department of Internal Medicine, Seoul St Mary's hospital, The Catholic University of Korea, College of Medicine, Seoul 137-701, South Korea.
authors.forename: Yeon Joon
authors.initials: YJ
authors.lastname: Park
authors.affiliation: Tae-Geun Gweon, Myung-Gyu Choi, Myong Ki Baeg, Chul-Hyun Lim, Jae Myung Park, In Seok Lee, Sang Woo Kim, Division of Gastroenterology, Department of Internal Medicine, Seoul St Mary's hospital, The Catholic University of Korea, College of Medicine, Seoul 137-701, South Korea.
authors.forename: Jong Wook
authors.initials: JW
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016360:Clostridioides difficile; D003015:Clostridium Infections / Q000150:complications / Q000175:diagnosis*; D003428:Cross Infection / Q000175:diagnosis*; D003967:Diarrhea / Q000150:complications / Q000382:microbiology*; D005260:Female; D006402:Hematologic Diseases / Q000150:complications / Q000382:microbiology*; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012008:Recurrence; D056910:Republic of Korea; D012189:Retrospective Studies; D012307:Risk Factors; D062606:Tertiary Care Centers
chemical_list: D000900:Anti-Bacterial Agents
keywords: Clinical outcome; Clostridium difficile associated diarrhea; Incidence; Intravenous immunoglobulin; Patients with hematologic disease