Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-11-28T11:50:06.393Z Has data issue: false hasContentIssue false

Clostridium difficile- Associated Diarrhea in a VA Medical Center Clustering of Cases, Association With Antibiotic Usage, and Impact on HIV-infected Patients

Published online by Cambridge University Press:  02 January 2015

Lona R. Mody
Affiliation:
Department of Medicine, Veterans Affairs New Jersey Health Care System, East Orange, New Jersey; and the, UMDNJ-New Jersey Medical School, Newark, New Jersey
Sharon M. Smith
Affiliation:
Department of Laboratory Medicine and Pathology, Veterans Affairs New Jersey Health Care System, East Orange, New Jersey; and the, UMDNJ-New Jersey Medical School, Newark, New Jersey
Lisa L. Dever*
Affiliation:
Department of Medicine, Veterans Affairs New Jersey Health Care System, East Orange, New Jersey; and the, UMDNJ-New Jersey Medical School, Newark, New Jersey
*
Medical Service, VA NJ Health Care System, 385 Tremont Ave, East Orange, NJ 07018

Abstract

A case-control study of patients with stools assayed for Clostridium difficile toxin over a 24-month period at a Veterans Affairs hospital found that the majority of cases (70.6%) occurred in temporal clusters. Clustering was particularly evident on a designated human immunodeficiency virus (RW) unit. Thirty-four (75.5%) of 45 HIV-infected patients with C difficile-associated diarrhea (CDAD) died during their hospitalization. Third-generation cephalosporins were the antibiotics most strongly associated with CDAD.

Type
Concise Communication
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2001

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Wilcox, MH, Cunniffe, JG, Trundle, C, Redpath, C. Financial burden of hospital-acquired Clostridium difficile infection. J Hosp Infect 1996;34:2330.CrossRefGoogle ScholarPubMed
2.Johnson, S, Gerding, DN. Clostridium difficile-associated diarrhea. Clin Infect Dis 1998;26:10271036.CrossRefGoogle ScholarPubMed
3.Climo, MW, Israel, DS, Wong, ES, Williams, D, Coudron, P, Markowitz, SM. Hospital-wide restriction of clindamycin: effect on the incidence of Clostridium difficile-associated diarrhea and cost. Ann Intern Med 1998;128:989995.CrossRefGoogle ScholarPubMed
4.van Dijck, P, Avesani, V, Delmee, M. Genotyping of outbreak-related and sporadic isolates of Clostridium difficile belonging to serogroup C. J Clin Microbiol 1996;34:30493055.Google Scholar
5.Hutin, Y, Molina, JM, Casin, I, Daix, V, Senaoui, P, Welker, Y, et al. Risk factors for Clostridium difficile-associated diarrhoea in HIV-infected patients. AIDS 1993;7:14411447.Google Scholar
6.Dever, LL, China, C, Eng, RH, O'Donovan, C, Johanson, WG JrVancomycin-resistant Enterococcus faecium in a Veterans Affairs Medical Center: association with antibiotic usage. Am J Infect Control 1998;26:4046.Google Scholar
7.Barbut, F, Meynard, JL, Guiguet, M, Avesani, V, Bochet, MV, Meyohas, MC, et al. Clostridium difficile-associated diarrhea in HIV-infected patients epidemiology and risk factors. J Acquir Immune Defic Syndr Hum Retrovirol 1997;16:176181.CrossRefGoogle ScholarPubMed
8.Lu, SS, Schwartz, JM, Simon, DM, Brandt, LJ. Clostridium difficile-associated diarrhea in patients with HIV positivity and AIDS: a prospective controlled study. Am J Gastroenterol 1994;89:12261229.Google ScholarPubMed
9.Cappell, MS, Philogene, C. Clostridium difficile infection is a treatable cause of diarrhea in patients with advanced human immunodeficiency virus infection: a study of seven consecutive patients admitted from 1986 to 1992 to a university teaching hospital. Am J Gastroenterol 1993;88:891897.Google Scholar
10.Hutin, Y, Casin, I, Lesprit, P, Welker, Y, Decazes, JM, Lagrange, P, et al. Prevalence of and risk fectors for Clostridium difficile colonization at admission to an infectious diseases ward. Clin Infect Dis 1997;24:920924.Google Scholar