Mortality and Clostridium difficile infection in an Australian setting
Article first published online: 7 JAN 2013
© 2013 Blackwell Publishing Ltd
Journal of Advanced Nursing
Volume 69, Issue 10, pages 2162–2171, October 2013
How to Cite
2012) Mortality and Clostridium difficile infection in an Australian setting Journal of Advanced Nursing 69(10), 2162–2171. doi: 10.1111/jan.12078, & (
- Issue published online: 13 SEP 2013
- Article first published online: 7 JAN 2013
- Manuscript Accepted: 1 DEC 2012
- Rosemary Norman Foundation
- Nurses Memorial Centre
- Royal College of Nursing Australia
- Tasmanian Florence Nightingale Grants
- Clostridium difficile-associated diarrhoea;
- Clostridium difficile infection;
- healthcare-associated infection;
- infection control;
To quantify the risk of death associated with Clostridium difficile infection, in an Australian tertiary hospital.
Two reviews examining Clostridium difficile infection and mortality indicate that Clostridium difficile infection is associated with increased mortality in hospitalized patients. Studies investigating the mortality of Clostridium difficile infection in settings outside of Europe and North America are required, so that the epidemiology of Clostridium difficile infection in these regions can be understood and appropriate prevention strategies made.
An observational non-concurrent cohort study design was used.
Data from all persons who had (exposed) and a matched sample of persons who did not have Clostridium difficile infection, for the calendar years 2007–2010, were analysed. The risk of dying within 30, 60, 90 and 180 days was compared using the two groups. Kaplan–Meier survival analysis and conditional logistic regression models were applied to the data to examine time to death and mortality risk adjusted for comorbidities using the Charlson Comorbidity Index.
One hundred and fifty-eight cases of infection were identified. A statistically significant difference in all-cause mortality was identified between exposed and non-exposed groups at 60 and 180 days. In a conditional regression model, mortality in the exposed group was significantly higher at 180 days.
In this Australian study, Clostridium difficile infection was associated with increased mortality. In doing so, it highlights the need for nurses to immediately instigate contact precautions for persons suspected of having Clostridium difficile infection and to facilitate a timely faecal collection for testing. Our findings support ongoing surveillance of Clostridium difficile infection and associated prevention and control activities.