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Related Experiment Videos

Clostridium difficile-associated diarrhea in the elderly.

L J Brandt1, K A Kosche, D A Greenwald

  • 1Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York 10467, USA.

The American Journal of Gastroenterology
|November 24, 1999
PubMed
Summary

Clostridium difficile (C. difficile)-associated diarrhea is not more severe in elderly patients, with no increased morbidity or mortality observed compared to younger individuals. Most elderly infections are hospital-acquired, but outcomes remain similar across age groups.

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Area of Science:

  • Infectious Diseases
  • Gastroenterology
  • Geriatrics

Background:

  • Clostridium difficile (C. difficile)-associated diarrhea is commonly thought to be more severe in the elderly.
  • Existing beliefs regarding increased morbidity and mortality in older adults are largely anecdotal.
  • Limited data exist to support the notion of increased disease severity in elderly patients.

Purpose of the Study:

  • To investigate and compare the morbidity and mortality associated with C. difficile-associated diarrhea in elderly versus younger patients.
  • To evaluate the impact of age on the severity of C. difficile infection.
  • To assess treatment response in different age groups.

Main Methods:

  • Prospective evaluation of 89 inpatients diagnosed with C. difficile-associated diarrhea.

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  • Patients were divided into two age groups: < 60 years (younger) and >= 60 years (elderly).
  • Comparison of mortality, morbidity, treatment response, white blood cell counts, and infection acquisition source between groups.

    • Main Results:

    • No significant difference in mortality or morbidity was found between elderly and younger patients with C. difficile-associated diarrhea.
    • Elderly patients were more likely to have hospital-acquired infections (89% vs. 50%) and elevated white blood cell counts (60% vs. 26%).
    • Standard treatment showed similar efficacy in both age groups.

    Conclusions:

    • C. difficile-associated diarrhea in the elderly is frequently acquired in institutional settings and may be overlooked.
    • The elderly population does not experience increased morbidity or mortality from C. difficile diarrhea.
    • Evidence does not support the hypothesis that C. difficile-associated diarrhea is more severe in the elderly compared to the young.