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Related Experiment Videos

Clostridium difficile colitis: an increasingly aggressive iatrogenic disease?

Arden M Morris1, Blair A Jobe, Mark Stoney

  • 1Robert Wood Johnson Clinical Scholars Program, University of Washington, Seattle, WA 98195-7183, USA. morrisa@u.washington.edu

Archives of Surgery (Chicago, Ill. : 1960)
|October 4, 2002
PubMed
Summary

Clostridium difficile colitis cases are rising, leading to increased mortality. Early recognition and aggressive treatment are crucial for all patients on antibiotics, as risk factors like immunocompromise are no longer solely predictive of death.

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Area of Science:

  • Infectious Diseases
  • Gastroenterology
  • Epidemiology

Background:

  • Clostridium difficile colitis diagnosis is increasing.
  • Patient outcomes associated with C. difficile colitis are worsening.
  • Rising incidence necessitates understanding current risk factors and outcomes.

Purpose of the Study:

  • To analyze trends in Clostridium difficile colitis frequency and outcomes.
  • To identify patient groups at higher risk for severe C. difficile colitis.
  • To evaluate mortality rates and need for surgical intervention.

Main Methods:

  • Retrospective cohort study.
  • Involved 157 patients diagnosed with C. difficile colitis between 1994-2000 at a university hospital.
  • Outcomes assessed included disease resolution, operative intervention, and death.

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Main Results:

  • Overall C. difficile colitis cases rose by over 30% compared to a previous decade.
  • Immunocompromised patients (post-transplant, chemotherapy, HIV) had a 20% mortality rate.
  • Patients with diabetes/renal failure had a 13% mortality rate.
  • Overall mortality increased significantly to 15.3% from 3.5%.

Conclusions:

  • Clostridium difficile colitis frequency remains high with increasing mortality.
  • Immunocompromise and delayed diagnosis were not associated with higher mortality in this series.
  • All patients on antibiotics are at risk and require prompt medical intervention.