Outcomes in community-acquired Clostridium difficile infection

S. Khanna, D. S. Pardi, S. L. Aronson, P. P. Kammer, L. M. Baddour

Research output: Contribution to journalArticle

52 Citations (Scopus)

Abstract

Background Community-acquired Clostridium difficile infection (CA-CDI) is an increasingly appreciated condition. It is being described in populations lacking traditional predisposing factors that have been previously considered at low-risk for this infection. As most studies of CDI are hospital-based, outcomes in these patients are not well known. Aim To examine outcomes and their predictors in patients with CA-CDI. Methods A sub-group analysis of a population-based epidemiological study of CDI in Olmsted county, Minnesota from 1991-2005 was performed. Data regarding outcomes, including severity, treatment response, need for hospitalisation and recurrence were analysed. Results Of 157 CA-CDI cases, the median age was 50 years and 75.3% were female. Among all CA-CDI cases, 40% required hospitalisation, 20% had severe and 4.4% had severe-complicated infection, 20% had treatment failure and 28% had recurrent CDI. Patients who required hospitalisation were significantly older (64 years vs. 44 years, P < 0.001), more likely to have severe disease (33.3% vs. 11.7%, P = 0.001), and had higher mean Charlson comorbidity index scores (2.06 vs. 0.84, P = 0.001). They had similar treatment failure and recurrence rates as patients who did not require hospitalisation. Conclusions Community-acquired Clostridium difficile infection can be associated with complications and poor outcomes, including hospitalisation and severe Clostridium difficile infection. As the incidence of community-acquired Clostridium difficile infection increases, clinicians should be aware of risk factors (increasing age, comorbid conditions and disease severity) that predict the need for hospitalisation and complications in patients with community-acquired Clostridium difficile infection.

Original languageEnglish (US)
Pages (from-to)613-618
Number of pages6
JournalAlimentary Pharmacology and Therapeutics
Volume35
Issue number5
DOIs
StatePublished - Mar 2012

Fingerprint

Clostridium Infections
Clostridium difficile
Hospitalization
Treatment Failure
Recurrence
Infection
Causality
Population
Comorbidity
Epidemiologic Studies
Incidence

ASJC Scopus subject areas

  • Pharmacology (medical)

Cite this

Khanna, S., Pardi, D. S., Aronson, S. L., Kammer, P. P., & Baddour, L. M. (2012). Outcomes in community-acquired Clostridium difficile infection. Alimentary Pharmacology and Therapeutics, 35(5), 613-618. https://doi.org/10.1111/j.1365-2036.2011.04984.x

Outcomes in community-acquired Clostridium difficile infection. / Khanna, S.; Pardi, D. S.; Aronson, S. L.; Kammer, P. P.; Baddour, L. M.

In: Alimentary Pharmacology and Therapeutics, Vol. 35, No. 5, 03.2012, p. 613-618.

Research output: Contribution to journalArticle

Khanna, S, Pardi, DS, Aronson, SL, Kammer, PP & Baddour, LM 2012, 'Outcomes in community-acquired Clostridium difficile infection', Alimentary Pharmacology and Therapeutics, vol. 35, no. 5, pp. 613-618. https://doi.org/10.1111/j.1365-2036.2011.04984.x
Khanna, S. ; Pardi, D. S. ; Aronson, S. L. ; Kammer, P. P. ; Baddour, L. M. / Outcomes in community-acquired Clostridium difficile infection. In: Alimentary Pharmacology and Therapeutics. 2012 ; Vol. 35, No. 5. pp. 613-618.
@article{0cdb013001b147f3aa93dcc543806f45,
title = "Outcomes in community-acquired Clostridium difficile infection",
abstract = "Background Community-acquired Clostridium difficile infection (CA-CDI) is an increasingly appreciated condition. It is being described in populations lacking traditional predisposing factors that have been previously considered at low-risk for this infection. As most studies of CDI are hospital-based, outcomes in these patients are not well known. Aim To examine outcomes and their predictors in patients with CA-CDI. Methods A sub-group analysis of a population-based epidemiological study of CDI in Olmsted county, Minnesota from 1991-2005 was performed. Data regarding outcomes, including severity, treatment response, need for hospitalisation and recurrence were analysed. Results Of 157 CA-CDI cases, the median age was 50 years and 75.3{\%} were female. Among all CA-CDI cases, 40{\%} required hospitalisation, 20{\%} had severe and 4.4{\%} had severe-complicated infection, 20{\%} had treatment failure and 28{\%} had recurrent CDI. Patients who required hospitalisation were significantly older (64 years vs. 44 years, P < 0.001), more likely to have severe disease (33.3{\%} vs. 11.7{\%}, P = 0.001), and had higher mean Charlson comorbidity index scores (2.06 vs. 0.84, P = 0.001). They had similar treatment failure and recurrence rates as patients who did not require hospitalisation. Conclusions Community-acquired Clostridium difficile infection can be associated with complications and poor outcomes, including hospitalisation and severe Clostridium difficile infection. As the incidence of community-acquired Clostridium difficile infection increases, clinicians should be aware of risk factors (increasing age, comorbid conditions and disease severity) that predict the need for hospitalisation and complications in patients with community-acquired Clostridium difficile infection.",
author = "S. Khanna and Pardi, {D. S.} and Aronson, {S. L.} and Kammer, {P. P.} and Baddour, {L. M.}",
year = "2012",
month = "3",
doi = "10.1111/j.1365-2036.2011.04984.x",
language = "English (US)",
volume = "35",
pages = "613--618",
journal = "Alimentary Pharmacology and Therapeutics",
issn = "0269-2813",
publisher = "Wiley-Blackwell",
number = "5",

}

TY - JOUR

T1 - Outcomes in community-acquired Clostridium difficile infection

AU - Khanna, S.

AU - Pardi, D. S.

AU - Aronson, S. L.

AU - Kammer, P. P.

AU - Baddour, L. M.

PY - 2012/3

Y1 - 2012/3

N2 - Background Community-acquired Clostridium difficile infection (CA-CDI) is an increasingly appreciated condition. It is being described in populations lacking traditional predisposing factors that have been previously considered at low-risk for this infection. As most studies of CDI are hospital-based, outcomes in these patients are not well known. Aim To examine outcomes and their predictors in patients with CA-CDI. Methods A sub-group analysis of a population-based epidemiological study of CDI in Olmsted county, Minnesota from 1991-2005 was performed. Data regarding outcomes, including severity, treatment response, need for hospitalisation and recurrence were analysed. Results Of 157 CA-CDI cases, the median age was 50 years and 75.3% were female. Among all CA-CDI cases, 40% required hospitalisation, 20% had severe and 4.4% had severe-complicated infection, 20% had treatment failure and 28% had recurrent CDI. Patients who required hospitalisation were significantly older (64 years vs. 44 years, P < 0.001), more likely to have severe disease (33.3% vs. 11.7%, P = 0.001), and had higher mean Charlson comorbidity index scores (2.06 vs. 0.84, P = 0.001). They had similar treatment failure and recurrence rates as patients who did not require hospitalisation. Conclusions Community-acquired Clostridium difficile infection can be associated with complications and poor outcomes, including hospitalisation and severe Clostridium difficile infection. As the incidence of community-acquired Clostridium difficile infection increases, clinicians should be aware of risk factors (increasing age, comorbid conditions and disease severity) that predict the need for hospitalisation and complications in patients with community-acquired Clostridium difficile infection.

AB - Background Community-acquired Clostridium difficile infection (CA-CDI) is an increasingly appreciated condition. It is being described in populations lacking traditional predisposing factors that have been previously considered at low-risk for this infection. As most studies of CDI are hospital-based, outcomes in these patients are not well known. Aim To examine outcomes and their predictors in patients with CA-CDI. Methods A sub-group analysis of a population-based epidemiological study of CDI in Olmsted county, Minnesota from 1991-2005 was performed. Data regarding outcomes, including severity, treatment response, need for hospitalisation and recurrence were analysed. Results Of 157 CA-CDI cases, the median age was 50 years and 75.3% were female. Among all CA-CDI cases, 40% required hospitalisation, 20% had severe and 4.4% had severe-complicated infection, 20% had treatment failure and 28% had recurrent CDI. Patients who required hospitalisation were significantly older (64 years vs. 44 years, P < 0.001), more likely to have severe disease (33.3% vs. 11.7%, P = 0.001), and had higher mean Charlson comorbidity index scores (2.06 vs. 0.84, P = 0.001). They had similar treatment failure and recurrence rates as patients who did not require hospitalisation. Conclusions Community-acquired Clostridium difficile infection can be associated with complications and poor outcomes, including hospitalisation and severe Clostridium difficile infection. As the incidence of community-acquired Clostridium difficile infection increases, clinicians should be aware of risk factors (increasing age, comorbid conditions and disease severity) that predict the need for hospitalisation and complications in patients with community-acquired Clostridium difficile infection.

UR - http://www.scopus.com/inward/record.url?scp=84856712211&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84856712211&partnerID=8YFLogxK

U2 - 10.1111/j.1365-2036.2011.04984.x

DO - 10.1111/j.1365-2036.2011.04984.x

M3 - Article

C2 - 22229532

AN - SCOPUS:84856712211

VL - 35

SP - 613

EP - 618

JO - Alimentary Pharmacology and Therapeutics

JF - Alimentary Pharmacology and Therapeutics

SN - 0269-2813

IS - 5

ER -