D Schmid1, H W Kuo2, E Simons3, E E Kanitz4, J Wenisch5, F Allerberger6, C Wenisch7. 1. Austrian Agency for Health and Food Safety (AGES), Währingerstr. 25a, 1090 Vienna, Austria. Electronic address: daniela.schmid@ages.at. 2. Austrian Agency for Health and Food Safety (AGES), Währingerstr. 25a, 1090 Vienna, Austria. Electronic address: hwkuo119@hotmail.com. 3. Austrian Agency for Health and Food Safety (AGES), Währingerstr. 25a, 1090 Vienna, Austria. Electronic address: erica.simons@ages.at. 4. Austrian Agency for Health and Food Safety (AGES), Währingerstr. 25a, 1090 Vienna, Austria. Electronic address: elisabeth.kanitz@ages.at. 5. Kaiser Franz Josef-Hospital, Department for Infectious Diseases, Kundratstr. 3, 1010 Vienna, Austria. Electronic address: judith.wenisch@wienkav.at. 6. Austrian Agency for Health and Food Safety (AGES), Währingerstr. 25a, 1090 Vienna, Austria. Electronic address: franz.allerberger@ages.at. 7. Kaiser Franz Josef-Hospital, Department for Infectious Diseases, Kundratstr. 3, 1010 Vienna, Austria. Electronic address: christoph.wenisch@wienkav.at.
Abstract
BACKGROUND: Clostridium difficile infection is the leading cause of gastroenteritis-associated deaths in the industrialized world, followed by infection with norovirus. METHODS: Using a cohort study design, we compared 90 inpatients with diarrhea due to C. difficile infection (CDI) with 180 inpatients with diarrhea due to other infectious agents (including 55% with norovirus infection) with respect to complications and all-cause mortality. The effects of age, severity of underlying diseases and additional infections were assessed by stratified analyses. RESULTS: Diarrhea recurrence occurred 8.9 (95%CI: 2.9-27.3) times more often in CDI independent of age and severity of comorbidities. The all-cause mortality in CDI patients pre-discharge and at 30 and 180 days, respectively, was 20.0%, 17.0% and 42.3% versus 7.2%, 6.7% and 22.5% in non-CDI diarrhea patients. Among those patients with low comorbidities, who were younger than 65 years and without additional infections, the all-cause pre-discharge, 30-day and 180-day mortality risks were significantly higher for the CDI diarrhea patients than the non-CDI diarrhea patients. This association was not observed among patients with an older age, more severe comorbidities or additional infections. CONCLUSION: CDI results in higher all-cause mortality than diarrhea due to other infectious agents in younger patients with low comorbidities.
BACKGROUND:Clostridium difficileinfection is the leading cause of gastroenteritis-associated deaths in the industrialized world, followed by infection with norovirus. METHODS: Using a cohort study design, we compared 90 inpatients with diarrhea due to C. difficileinfection (CDI) with 180 inpatients with diarrhea due to other infectious agents (including 55% with norovirus infection) with respect to complications and all-cause mortality. The effects of age, severity of underlying diseases and additional infections were assessed by stratified analyses. RESULTS:Diarrhea recurrence occurred 8.9 (95%CI: 2.9-27.3) times more often in CDI independent of age and severity of comorbidities. The all-cause mortality in CDIpatients pre-discharge and at 30 and 180 days, respectively, was 20.0%, 17.0% and 42.3% versus 7.2%, 6.7% and 22.5% in non-CDI diarrheapatients. Among those patients with low comorbidities, who were younger than 65 years and without additional infections, the all-cause pre-discharge, 30-day and 180-day mortality risks were significantly higher for the CDI diarrheapatients than the non-CDI diarrheapatients. This association was not observed among patients with an older age, more severe comorbidities or additional infections. CONCLUSION:CDI results in higher all-cause mortality than diarrhea due to other infectious agents in younger patients with low comorbidities.
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