title: Impact of malignancy on Clostridium difficile infection.
abstract: OBJECTIVE
  The purpose of this study was to investigate the impact of malignancy and chemotherapy on the clinical and microbiological characteristics of Clostridium difficile infections (CDI).
  
  
  METHODS
  CDI patients with a history of malignancy within 5 years were defined as the cancer group. The characteristics of the patients were compared according to the presence of malignancy.
  
  
  RESULTS
  Of 580 patients with CDI, 159 (27.4 %) belonged to the cancer group and 421 (72.6 %) to the non-cancer group. More of the patients in the cancer group than those in the non-cancer group had been hospitalized within the prior 2 months (P < 0.001). Leukocytosis was more common in the non-cancer group (P = 0.034), while infection by PCR ribotype 017 strains was more common in the cancer group, with marginal significance (P = 0.07). Recurrence was more frequent in the cancer group (20.4 % vs. 9.5 %, P =0.005) and cancer was an independent risk factor for recurrence of CDI (OR = 2.66, 95 % CI 1.34-5.29, P =0.005). Age also contributed to the recurrence of CDI (OR = 1.03, 95 % CI 1.00-1.06, P =0.026).
  
  
  CONCLUSIONS
  Malignancy and age are independent risk factors for recurrence of CDI. Cancer patients require careful observation for recurrence after treatment of CDI.
authors.affiliation: Department of Surgery, Hanyang University College of Medicine, 222-1, Wangsimni-ro, Seongdong-gu, Seoul, Korea.
authors.forename: M S
authors.initials: MS
authors.lastname: Chung
authors.affiliation: Department of Internal Medicine, Hanyang University College of Medicine, 222-1, Wangsimni-ro, Seongdong-gu, Seoul, Korea.
authors.forename: J
authors.initials: J
authors.lastname: Kim
authors.affiliation: Department of Laboratory Medicine, Hanyang University College of Medicine, 222-1, Wangsimni-ro, Seongdong-gu, Seoul, Korea.
authors.forename: J O
authors.initials: JO
authors.lastname: Kang
authors.affiliation: Department of Internal Medicine, Hanyang University College of Medicine, 222-1, Wangsimni-ro, Seongdong-gu, Seoul, Korea. paihyunjoo@gmail.com.
authors.forename: H
authors.initials: H
authors.lastname: Pai
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D016360:Clostridioides difficile / Q000302:isolation & purification*; D003015:Clostridium Infections / Q000150:complications* / Q000453:epidemiology* / Q000382:microbiology; D004358:Drug Therapy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000188:drug therapy; D012008:Recurrence; D012189:Retrospective Studies
chemical_list: D000970:Antineoplastic Agents