Serum 25-Hydroxyvitamin D Levels are not Associated with Adverse Outcomes in Clostridium Difficile Infection.
Clostridium difficile infection (CDI) is a significant source of healthcare-associated morbidity and mortality. This study investigated whether serum 25-hydroxyvitamin D is associated with adverse outcomes from CDI. Patients with CDI were prospectively enrolled. Charts were reviewed and serum 25-hydroxyvitamin D was measured. The primary outcome was a composite definition of severe disease: fever (temperature >38°C), acute organ dysfunction, or serum white blood cell count >15,000 cells/µL within 24-48 hours of diagnosis; lack of response to therapy by day 5; and intensive care unit admission; colectomy; or death within 30 days. Sixty-seven patients were included in the final analysis. Mean (±SD) serum 25-hydroxyvitamin D was 26.1 (±18.54) ng/mL. Severe disease, which occurred in 26 (39%) participants, was not associated with serum 25-hydroxyvitamin D [odds ratio (OR) 1.00; 95% confidence interval (CI) 0.96-1.04]. In the adjusted model for severe disease only serum albumin (OR 0.12; 95%CI 0.02-0.64) and diagnosis by detection of stool toxin (OR 5.87; 95%CI 1.09-31.7) remained independent predictors. We conclude that serum 25-hydroxyvitamin D is not associated with the development of severe disease in patients with CDI.
Division of Gastroenterology, Hepatology and Nutrition, University of Chicago , IL, USA.
Dejan
D
Micic
Department of Internal Medicine, University of Michigan Health System , Ann Arbor, MI, USA ; Division of Infectious Diseases, University of Michigan Health System , Ann Arbor, MI, USA.
Krishna
K
Rao
Department of Internal Medicine, University of Michigan Health System , Ann Arbor, MI, USA ; Department of Microbiology and Immunology, University of Michigan Health System , Ann Arbor, MI, USA.
Bruno Caetano
BC
Trindade
Department of Internal Medicine, University of Michigan Health System , Ann Arbor, MI, USA ; Division of Infectious Diseases, University of Michigan Health System , Ann Arbor, MI, USA.
Seth T
ST
Walk
University of Michigan Medical School , Ann Arbor, MI, USA.
Elizabeth
E
Chenoweth
Department of Internal Medicine, University of Michigan Health System , Ann Arbor, MI, USA ; Division of Infectious Diseases, University of Michigan Health System , Ann Arbor, MI, USA.
Ruchika
R
Jain
Department of Internal Medicine, University of Michigan Health System , Ann Arbor, MI, USA.
Itishree
I
Trivedi
Department of Internal Medicine, University of Michigan Health System , Ann Arbor, MI, USA ; Division of Infectious Diseases, University of Michigan Health System , Ann Arbor, MI, USA.
Kavitha
K
Santhosh
Vincent B
VB
Young
David M
DM
Aronoff
Clostridium difficile; Vitamin D; biomarkers; colitis