Hematologic diseases: High risk of Clostridium difficile associated diarrhea

• Published in: World journal of gastroenterology : WJG 2014-06, Vol.20 (21), p.6602-6607
• Main Authors: Gweon, Tae-Geun, Choi, Myung-Gyu, Baeg, Myong Ki, Lim, Chul-Hyun, Park, Jae Myung, Lee, In Seok, Kim, Sang Woo, Lee, Dong-Gun, Park, Yeon Joon, Lee, Jong Wook
• Format: Article
• Language: English
• Subjects: Adult; Aged; Anti-Bacterial Agents - therapeutic use; associated; Clostridium; Clostridium difficile; Clostridium Infections - complications; Clostridium Infections - diagnosis; Cross Infection - diagnosis; diarrhea; Diarrhea - complications; Diarrhea - microbiology; difficile; Female; Hematologic Diseases - complications; Hematologic Diseases - microbiology; Hospitalization; Humans; Incidenc; Male; Middle Aged; Multivariate Analysis; Recurrence; Republic of Korea; Retrospective Studies; Retrospective Study; Risk Factors; Tertiary Care Centers
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.v20.i21.6602

AIM:To investigate the incidence and clinical outcome of Clostridium difficile(C.difficile)associated diarrhea(CDAD)in patients with hematologic disease.METHODS:We retrospectively reviewed the medical records of patients who underwent C.difficile testing in a tertiary hospital in 2011.The incidence and risk factors for CDAD and its clinical course including recurrence and mortality were assessed in patients with hematologic disease and compared with those in patients with nonhematologic disease.RESULTS:About 320 patients were diagnosed with CDAD(144 patients with hematologic disease;176with nonhematologic disease).The incidence of CDAD in patients with hematologic disease was estimated to be 36.7 cases/10000 patient hospital days,which was higher than the 5.4 cases/10000 patient hospital days in patients with nonhematologic disease.Recurrence of CDAD was more frequent in patients with hematologic disease compared to those with nonhematologic disease(18.8%vs 8.5%,P<0.01),which was associated with higher re-use of causative antibiotics for CDAD.Mortality due to CDAD did not differ between the two groups.Multivariate analysis showed that intravenous immunoglobulin was the only significant factor associated with a lower rate of recurrence of CDAD in patients with hematologic disease.CONCLUSION:The incidence and recurrence of CDAD was higher in patients with hematologic disease than in those with nonhematologic disease.