title: Prolonged Clostridium difficile Infection May Be Associated With Vitamin D Deficiency.
abstract: Clostridium difficile infection (CDI) is one of the leading causes of hospital-acquired infections, creating a financial burden for the U.S. healthcare system. Reports suggest that vitamin D-deficient CDI patients incur higher healthcare-associated expenses and longer lengths of stay compared to nondeficient counterparts. The objective here was to evaluate the relationship between vitamin D level and CDI recurrence.
  
  
  
  A retrospective chart review was conducted for 112 patients with vitamin D level drawn within 3 months of CDI diagnosis. Recurrence, severity of disease, 30-day mortality, and course of CDI were assessed.
  
  
  
  The vitamin D-deficient group included 56 patients, and the normal group included 56 patients. The mean age of vitamin D-deficient and -sufficient groups was 68 ± 15.7 and 71 ± 14.4 years, respectively. The mean 25(OH) D level in the deficient group was 11.7 ± 4.6 ng/mL, and it was 36.2 ± 16.2 ng/mL in the normal group. A longer course of diarrhea was apparent in the vitamin D-deficient group compared to the normal group: 6.1 days (95% confidence interval [CI], 4.9-7.2) vs 4.2 days (95% CI, 3.5-4.9; P = .01). Sepsis rate was 24% in vitamin D-deficient group and 13% in normal group (P = .03). There were no differences in CDI recurrence, length of stay, severity of illness, and mortality with respect to vitamin D status.
  
  
  
  There may be an association between course of diarrhea and increased rate of sepsis in vitamin D-deficient CDI patients.
authors.affiliation: Department of Internal Medicine, Akron General Medical Center, Akron, Ohio dap3ac3@gmail.com.
authors.forename: Ken Koon
authors.initials: KK
authors.lastname: Wong
authors.affiliation: Department of Medicine, Northeast Ohio Medical University, Rootstown, Ohio.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Akron General Medical Center, Akron, Ohio Department of Medicine, Northeast Ohio Medical University, Rootstown, Ohio Division of Infectious Disease, Akron General Medical Center, Akron, Ohio.
authors.forename: Richard R
authors.initials: RR
authors.lastname: Watkins
authors.affiliation: Department of Internal Medicine, Akron General Medical Center, Akron, Ohio Department of Medicine, Northeast Ohio Medical University, Rootstown, Ohio.
authors.forename: Nairmeen
authors.initials: N
authors.lastname: Haller
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003015:Clostridium Infections / Q000209:etiology* / Q000401:mortality / Q000503:physiopathology; D003967:Diarrhea / Q000382:microbiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease / Q000453:epidemiology; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D012008:Recurrence; D012189:Retrospective Studies; D018805:Sepsis / Q000453:epidemiology; D012720:Severity of Illness Index; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000150:complications*
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D
keywords: adult; gastroenterology; immunonutrition; life cycle; nutrition; research and diseases; sepsis; vitamins