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Findings of a hospital surveillance-based outcome evaluation study for Clostridium difficile-associated colitis.
Clin Microbiol Infect. 2014 Apr 28;
Authors: Varkonyi I, Rakoczi E, Misak O, Komaromi E, Kardos L, Lampe Z, Szilvassy Z
Abstract
We completed a prospective study of 164 patients involved in a Clostridium difficile surveillance program, evaluating a range of variables such as disease severity, treatment regimen, and known clinical risk factors, for their effect on case lethality. The aim of this study was to determine if there are any additional clinical variables worth considering for inclusion in the therapeutic decision making process. Beyond common risk factors, secondary immunodeficiencies such as diabetes mellitus, malignancy, autoimmune disease, immunosuppressive therapy and chronic hepatitis were assessed. Overall case lethality was 23%. There was a suggestion that regular proton pump inhibitor use in past medical history might be associated with greater lethality. Immunosuppressive therapy within a month prior to onset of diarrhoea was associated with a significant 4-fold lethality increase. The latter factor may have the potential to further improve therapeutic judgment if used as an explicit component of a revised scoring system. In relation to Clostridium difficile-associated colitis, immunosuppressive therapy as a red flag entity described here has not been published so far. This article is protected by copyright. All rights reserved.
PMID: 24766614 [PubMed - as supplied by publisher]