Publication: Epidemiology of suspected Clostridium difficile-associated hospital-acquired diarrhea in hospitalized patients at Siriraj Hospital.
Issued Date
2011-02-01
Resource Type
ISSN
01252208
Other identifier(s)
2-s2.0-80054833433
Rights
Mahidol University
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of the Medical Association of Thailand = Chotmaihet thangphaet. Vol.94 Suppl 1, (2011)
Suggested Citation
Wilawan Thipmontree, Pattarachai Kiratisin, Sathaporn Manatsathit, Visanu Thamlikitkul Epidemiology of suspected Clostridium difficile-associated hospital-acquired diarrhea in hospitalized patients at Siriraj Hospital.. Journal of the Medical Association of Thailand = Chotmaihet thangphaet. Vol.94 Suppl 1, (2011). Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/12669
Research Projects
Organizational Units
Authors
Journal Issue
Thesis
Title
Epidemiology of suspected Clostridium difficile-associated hospital-acquired diarrhea in hospitalized patients at Siriraj Hospital.
Other Contributor(s)
Abstract
Clostridium difficile-associated disease (CDAD) is an important cause of hospital-acquired diarrhea. To determine the prevalence, risk factors, diagnosis, treatments and outcomes of the patients with CDAD in hospitalized patients at Siriraj Hospital. The medical records of hospitalized patients aged older than 14 years who developed hospital-acquired diarrhea and their stool samples were sent for detection of C. difficile toxins from March to June 2008 were reviewed. Risk factors of CDAD were identified by reviewing medical records of CDAD patients (case group) and patients who had hospital-acquired diarrhea without C. difficile toxins (control group). The patients in the control group were matched with the case group in terms of gender and age. Three hundred and twenty three stool samples obtained from 255 adult hospitalized patients were sent to microbiology laboratory for detection of C. difficile toxins. The prevalence of CDAD in suspected C. difficile-associated hospital-acquired diarrhea was 12.3% (95% CI 8.5% to 17.6%). Univariate analysis showed that antibiotic use ( > or =2 agents), proton pump inhibitor (PPI) use, hematologic malignancy, receiving chemotherapy or immunosuppressive agents were associated with CDAD. Multivariate analysis revealed that only antibiotic use ( > or =2 agents), PPI use and hematologic malignancy were independent risk factors associated with CDAD. Nasogastric intubation was observed to be associated with CDAD as a protective factor from both univariate and multivariate analyses. Diagnosis of CDAD in most of the patients was made by a presence of C. difficile toxin in their stool samples. Response rate to metronidazole was 74.5%. The recurrence rate of CDAD was 3.2%. The mortality rate due to CDAD was 3.2%. CDAD is not uncommon in the patients with hospital-acquired diarrhea especially in those who have hematologic malignancy, receive multiple antibiotics or receive PPI. Metronidazole is an acceptable treatment for CDAD. The recurrence rate of CDAD and mortality rate due to CDAD are low.