Univariate and multivariate analysis of risk factors for severe clostridium difficile-associated diarrhoea: Importance of co-morbidity and serum C-reactive protein

World Journal of Gastroenterology

Volumn 14, Issue 27, 2008, Pages 4338-4341

  Hardt, Christian ^a   Berns, Thomas ^b   Treder, Wolfgang ^c   Domoulin, Franz Ludwig ^a  

^a Gemeinschaftskrankenhaus Bonn   (Germany)

^b St Agnes Hospital Bocholt gGmbH   (Germany)

^c Münster Center for Laboratory Diagnostics   (Germany)

Author keywords

30 day mortality; C reactive protein; Clostridium difficile; Co morbidity; Nosocomial diarrhoea

Indexed keywords

C REACTIVE PROTEIN;

ADULT; AGED; ARTICLE; CLOSTRIDIUM DIFFICILE; COMORBIDITY; CONTROLLED STUDY; DIARRHEA; DISEASE ASSOCIATION; DISEASE SEVERITY; FEMALE; HOSPITAL PATIENT; HUMAN; HYPOVOLEMIA; LENGTH OF STAY; MAJOR CLINICAL STUDY; MALE; MORTALITY; MULTIVARIATE ANALYSIS; NONHUMAN; PROTEIN BLOOD LEVEL; RETROSPECTIVE STUDY; RISK FACTOR; SCORING SYSTEM; UNIVARIATE ANALYSIS; ADOLESCENT; BIOSYNTHESIS; METABOLISM; MICROBIOLOGY; MIDDLE AGED;

ADOLESCENT; ADULT; AGED; AGED, 80 AND OVER; C-REACTIVE PROTEIN; CLOSTRIDIUM DIFFICILE; DIARRHEA; FEMALE; HUMANS; HYPOVOLEMIA; MALE; MIDDLE AGED; MULTIVARIATE ANALYSIS; RETROSPECTIVE STUDIES; RISK FACTORS;

EID: 55949093523     PISSN: 10079327     EISSN: None     Source Type: Journal    
DOI: 10.3748/wjg.14.4338     Document Type: Article

References (30)

1. Loo VG, Libman MD, Miller MA, Bourgault AM, Frenette CH, Kelly M, Michaud S, Nguyen T, Poirier L, Vibien A, Horn R, Laflamme PJ, Rene P. Clostridium difficile: a formidable foe. CMAJ 2004; 171: 47-48
2. Bartlett JG. Narrative review: the new epidemic of Clostridium difficile-associated enteric disease. Ann Intern Med 2006; 145: 758-764
3. Aslam S, Musher DM. An update on diagnosis, treatment, and prevention of Clostridium difficile-associated disease. Gastroenterol Clin North Am 2006; 35: 315-335
4. McFarland LV. Diarrhoea associated with antibiotic use. BMJ 2007; 335: 54-55
5. McFarland LV. Update on the changing epidemiology of Clostridium difficile-associated disease. Nat Clin Pract Gastroenterol Hepatol 2008; 5: 40-48
6. Miller MA. Clinical management of Clostridium difficile-associated disease. Clin Infect Dis 2007; 45 Suppl 2: S122-S128
7. Warny M, Pepin J, Fang A, Killgore G, Thompson A, Brazier J, Frost E, McDonald LC. Toxin production by an emerging strain of Clostridium difficile associated with outbreaks of severe disease in North America and Europe. Lancet 2005; 366: 1079-1084
8. Loo VG, Poirier L, Miller MA, Oughton M, Libman MD, Michaud S, Bourgault AM, Nguyen T, Frenette C, Kelly M, Vibien A, Brassard P, Fenn S, Dewar K, Hudson TJ, Horn R, Rene P, Monczak Y, Dascal A. A predominantly clonal multi-institutional outbreak of Clostridium difficile-associated diarrhea with high morbidity and mortality. N Engl J Med 2005; 353: 2442-2449
9. Bartlett JG, Perl TM. The new Clostridium difficile - what does it mean? N Engl J Med 2005; 353: 2503-2505
10. Ricciardi R, Rothenberger DA, Madoff RD, Baxter NN. Increasing prevalence and severity of Clostridium difficile colitis in hospitalized patients in the United States. Arch Surg 2007; 142: 624-631; discussion 631
11. Kato H, Kato H, Nakamura M, Nakamura A. A case of toxic megacolon secondary to Clostridium difficile-associated diarrhea worsened after administration of an antimotility agent and molecular analysis of recovered isolates. J Gastroenterol 2007; 42: 507-508
12. Pepin J, Valiquette L, Gagnon S, Routhier S, Brazeau I. Outcomes of Clostridium difficile-associated disease treated with metronidazole or vancomycin before and after the emergence of NAP1/027. Am J Gastroenterol 2007; 102: 2781-2788
13. Gould CV, McDonald LC. Bench-to-bedside review: Clostridium difficile colitis. Crit Care 2008; 12: 203
14. Cunney RJ, Magee C, McNamara E, Smyth EG, Walshe J. Clostridium difficile colitis associated with chronic renal failure. Nephrol Dial Transplant 1998; 13: 2842-2846
15. McFarland LV, Surawicz CM, Stamm WE. Risk factors for Clostridium difficile carriage and C. difficile-associated diarrhea in a cohort of hospitalized patients. J Infect Dis 1990; 162: 678-684
16. Kyne L, Merry C, O'Connell B, Kelly A, Keane C, O'Neill D. Factors associated with prolonged symptoms and severe disease due to Clostridium difficile. Age Ageing 1999; 28: 107-113
17. Dial S, Delaney JA, Schneider V, Suissa S. Proton pump inhibitor use and risk of community-acquired Clostridium difficile-associated disease defined by prescription for oral vancomycin therapy. CMAJ 2006; 175: 745-748
18. Kyne L, Sougioultzis S, McFarland LV, Kelly CP. Underlying disease severity as a major risk factor for nosocomial Clostridium difficile diarrhea. Infect Control Hosp Epidemiol 2002; 23: 653-659
19. Thorson MA, Bliss DZ, Savik K. Re-examination of risk factors for non-Clostridium difficile-associated diarrhoea in hospitalized patients. J Adv Nurs 2008; 62: 354-364
20. van der Kooi TI, Koningstein M, Lindemans A, Notermans DW, Kuijper E, van den Berg R, Boshuizen H, Filius PM, van den Hof S. Antibiotic use and other risk factors at hospital level for outbreaks with Clostridium difficile PCR ribotype 027. J Med Microbiol 2008; 57: 709-716
21. Carignan A, Allard C, Pepin J, Cossette B, Nault V, Valiquette L. Risk of Clostridium difficile infection after perioperative antibacterial prophylaxis before and during an outbreak of infection due to a hypervirulent strain. Clin Infect Dis 2008; 46: 1838-1843
22. Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 1987; 40: 373-383
23. Hall WH, Ramachandran R, Narayan S, Jani AB, Vijayakumar S. An electronic application for rapidly calculating Charlson comorbidity score. BMC Cancer 2004; 4: 94
24. Musher DM, Manhas A, Jain P, Nuila F, Waqar A, Logan N, Marino B, Graviss EA. Detection of Clostridium difficile toxin: comparison of enzyme immunoassay results with results obtained by cytotoxicity assay. J Clin Microbiol 2007; 45: 2737-2739
25. Reichardt C, Chaberny IF, Kola A, Mattner F, Vonberg RP, Gastmeier P. [Dramatic increase of Clostridium difficile-associated diarrhea in Germany: has the new strain PCR-ribotype 027 already reached us?] Dtsch Med Wochenschr 2007; 132: 223-228
26. Andrews CN, Raboud J, Kassen BO, Enns R. Clostridium difficile-associated diarrhea: predictors of severity in patients presenting to the emergency department. Can J Gastroenterol 2003; 17: 369-373
27. Dharmarajan T, Sipalay M, Shyamsundar R, Norkus E, Pitchumoni C. Co-morbidity, not age predicts adverse outcome in clostridium difficile colitis. World J Gastroenterol 2000; 6: 198-201
28. Rubin MS, Bodenstein LE, Kent KC. Severe Clostridium difficile colitis. Dis Colon Rectum 1995; 38: 350-354
29. Moshkowitz M, Ben-Baruch E, Kline Z, Shimoni Z, Niven M, Konikoff F. Risk factors for severity and relapse of pseudomembranous colitis in an elderly population. Colorectal Dis 2007; 9: 173-177
30. Dial S, Delaney JA, Barkun AN, Suissa S. Use of gastric acid-suppressive agents and the risk of community-acquired Clostridium difficile-associated disease. JAMA 2005; 294: 2989-2995