Clostridium difficile Infection at a Medical Center in Southern Taiwan

Incidence, Clinical Features and Prognosis

Chih Huan Chung, Chi Jung Wu, Hsin Chun Lee, Jing Jou Yan, Chia-Ming Chang, Nan-Yao Lee, Po-Lin Chen, Ching Chi Lee, Yuan Pin Hung, Wen-Chien Ko

Research output: Contribution to journalArticle

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Abstract

Background/Purpose: An increase in incidence of Clostridium difficile infection (CDI) among Western countries has been noted in recent years. Epidemiological data of CDI are scarce in Taiwan. This study is intended to depict the clinical features of CDI at a medical center in Southern Taiwan. Methods: From January 1, 2007 to March 31, 2008, hospitalized patients with CDI (defined as the presence of gastrointestinal symptoms and fecal C. difficile toxin) were identified. Their medical records were reviewed for further evaluation. Results: A total of 86 cases of CDI were identified in the study period. The incidence was 42.6 cases per 100,000 patient-days, or 3.4 cases per 1,000 discharges, and was highest in intensive care units (110.6 cases per 100,000 patient-days). Variable incidence rates were noted in different wards, and prevalence was higher in the infectious ward. Diarrhea, fever, and abdominal distension were common in 82 (95.3%), 47 (54.7%), and 29 (33.7%) patients, respectively. Metronidazole was the initial therapeutic regimen for 83 (96.5%) patients. Prolonged diarrhea was noted in 31 (36.4%) patients, especially in those on hemodialysis therapy. Recurrence was noted in 7 (8.1%) patients. Fecal carriage of vancomycin-resistant Enterococcus colonization was found in three patients after therapy for CDI. All-cause mortality rate of patients with CDI at 30 days was 23.3%. Conclusion: CDI is increasingly being recognized within the medical departments, and should be considered in hospitalized adults with diarrhea, fever, or abdominal distension alone, or in combination.

Original languageEnglish
Pages (from-to)119-125
Number of pages7
JournalJournal of Microbiology, Immunology and Infection
Volume43
Issue number2
DOIs
Publication statusPublished - 2010 Apr 1

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Clostridium Infections
Clostridium difficile
Taiwan
Incidence
Diarrhea
Fever
Metronidazole
Medical Records
Intensive Care Units
Renal Dialysis
Therapeutics
Recurrence

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Immunology and Microbiology(all)
  • Microbiology (medical)
  • Infectious Diseases

Cite this

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title = "Clostridium difficile Infection at a Medical Center in Southern Taiwan: Incidence, Clinical Features and Prognosis",
abstract = "Background/Purpose: An increase in incidence of Clostridium difficile infection (CDI) among Western countries has been noted in recent years. Epidemiological data of CDI are scarce in Taiwan. This study is intended to depict the clinical features of CDI at a medical center in Southern Taiwan. Methods: From January 1, 2007 to March 31, 2008, hospitalized patients with CDI (defined as the presence of gastrointestinal symptoms and fecal C. difficile toxin) were identified. Their medical records were reviewed for further evaluation. Results: A total of 86 cases of CDI were identified in the study period. The incidence was 42.6 cases per 100,000 patient-days, or 3.4 cases per 1,000 discharges, and was highest in intensive care units (110.6 cases per 100,000 patient-days). Variable incidence rates were noted in different wards, and prevalence was higher in the infectious ward. Diarrhea, fever, and abdominal distension were common in 82 (95.3{\%}), 47 (54.7{\%}), and 29 (33.7{\%}) patients, respectively. Metronidazole was the initial therapeutic regimen for 83 (96.5{\%}) patients. Prolonged diarrhea was noted in 31 (36.4{\%}) patients, especially in those on hemodialysis therapy. Recurrence was noted in 7 (8.1{\%}) patients. Fecal carriage of vancomycin-resistant Enterococcus colonization was found in three patients after therapy for CDI. All-cause mortality rate of patients with CDI at 30 days was 23.3{\%}. Conclusion: CDI is increasingly being recognized within the medical departments, and should be considered in hospitalized adults with diarrhea, fever, or abdominal distension alone, or in combination.",
author = "Chung, {Chih Huan} and Wu, {Chi Jung} and Lee, {Hsin Chun} and Yan, {Jing Jou} and Chia-Ming Chang and Nan-Yao Lee and Po-Lin Chen and Lee, {Ching Chi} and Hung, {Yuan Pin} and Wen-Chien Ko",
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Clostridium difficile Infection at a Medical Center in Southern Taiwan : Incidence, Clinical Features and Prognosis. / Chung, Chih Huan; Wu, Chi Jung; Lee, Hsin Chun; Yan, Jing Jou; Chang, Chia-Ming; Lee, Nan-Yao; Chen, Po-Lin; Lee, Ching Chi; Hung, Yuan Pin; Ko, Wen-Chien.

In: Journal of Microbiology, Immunology and Infection, Vol. 43, No. 2, 01.04.2010, p. 119-125.

Research output: Contribution to journalArticle

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AU - Yan, Jing Jou

AU - Chang, Chia-Ming

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AU - Chen, Po-Lin

AU - Lee, Ching Chi

AU - Hung, Yuan Pin

AU - Ko, Wen-Chien

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N2 - Background/Purpose: An increase in incidence of Clostridium difficile infection (CDI) among Western countries has been noted in recent years. Epidemiological data of CDI are scarce in Taiwan. This study is intended to depict the clinical features of CDI at a medical center in Southern Taiwan. Methods: From January 1, 2007 to March 31, 2008, hospitalized patients with CDI (defined as the presence of gastrointestinal symptoms and fecal C. difficile toxin) were identified. Their medical records were reviewed for further evaluation. Results: A total of 86 cases of CDI were identified in the study period. The incidence was 42.6 cases per 100,000 patient-days, or 3.4 cases per 1,000 discharges, and was highest in intensive care units (110.6 cases per 100,000 patient-days). Variable incidence rates were noted in different wards, and prevalence was higher in the infectious ward. Diarrhea, fever, and abdominal distension were common in 82 (95.3%), 47 (54.7%), and 29 (33.7%) patients, respectively. Metronidazole was the initial therapeutic regimen for 83 (96.5%) patients. Prolonged diarrhea was noted in 31 (36.4%) patients, especially in those on hemodialysis therapy. Recurrence was noted in 7 (8.1%) patients. Fecal carriage of vancomycin-resistant Enterococcus colonization was found in three patients after therapy for CDI. All-cause mortality rate of patients with CDI at 30 days was 23.3%. Conclusion: CDI is increasingly being recognized within the medical departments, and should be considered in hospitalized adults with diarrhea, fever, or abdominal distension alone, or in combination.

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