Outcomes in community-acquired Clostridium difficile infection
Article first published online: 10 JAN 2012
© 2012 Blackwell Publishing Ltd
Alimentary Pharmacology & Therapeutics
Volume 35, Issue 5, pages 613–618, March 2012
How to Cite
Khanna, S., Pardi, D. S., Aronson, S. L., Kammer, P. P. and Baddour, L. M. (2012), Outcomes in community-acquired Clostridium difficile infection. Alimentary Pharmacology & Therapeutics, 35: 613–618. doi: 10.1111/j.1365-2036.2011.04984.x
- Issue published online: 3 FEB 2012
- Article first published online: 10 JAN 2012
- Manuscript Revised: 20 DEC 2011
- Manuscript Accepted: 20 DEC 2011
- Manuscript Revised: 18 DEC 2011
- Manuscript Received: 6 NOV 2011
- Rochester Epidemiology Project. Grant Number: R01 AG034676
- National Institute of Aging
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.
To examine outcomes and their predictors in patients with CA-CDI.
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.
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.
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.