Epidemiology, clinical manifestations, and outcome of Clostridium difficile-associated diarrhea.

摘要: OBJECTIVE Clostridium difficile gastrointestinal disease is an important nosocomial infection and associated with recent antibiotic use. This study evaluated C. difficile-associated diarrhea (CDAD) over a 2-yr period. METHODS All 60 patients enterotoxin in their stools, diarrhea, were retrospectively analyzed at 615-bed teaching hospital. Institution usage discharge medical diagnoses correlated the patients. RESULTS Thirty-eight (53%) had major or extreme admitting symptoms. Only four (7%) no co-morbid illness. The incidence of CDAD increased significantly (p < 0.05) after 4 wk hospitalization. No demographic temporal clustering was discovered. Leukocytosis (60%), leftward polymorphonuclear shift (47%), dehydration (30%), weight loss (23%), oliguria (12%) clinical findings. Among these subject 51 (85%) been on ceftriaxone and/or ceftazidime preceding 6 wk; ceftriaxone/ceftazidime highly 0.01) more cases than expected by alone. patient ticarcillin/clavulanate developed CDAD, although it most commonly used 0.00001). Higher mortality older debilitated nursing home residents. CONCLUSIONS Third-generation cephalosporin use development CDAD; did not. Morbidity significant, worse patients, likely to occur hospitalizations lasting longer wk.