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[Diarrhea associated with Clostridium difficile: experience at a secondary hospital]
Ana M de Isusi1, Elvira González, Pilar Gayoso
1Servicio Medicina Interna Hospital Cristal, Ourense, España.
Background And Objective:
Our purpose was to know the incidence, clinical profile, evolution and mortality of Clostridium difficile-associated diarrhea.
Patients And Method:
Retrospective study. Inpatients were included who had a positive toxin on stools or a diagnostic colonoscopy (pseudomembranous colitis) after ruling out other causes (n=113).
Results:
We observed a growing annual incidence (1.05, 1.7, and 2.6 per 1000 admissions in 1999, 2000 and 2001, respectively). Hyponatremia (OR=5.16) and vomiting (OR=3.09) were found to be worse-prognosis factors. Hyponatremia (OR=2.72) and chronic renal disease (OR=4.45) increased the mortality risk.
Conclusions:
The incidence of C. difficile-associated diarrhea is growing, probably in relation to increased clinical suspicion, wide antibiotics utilization, and old age of inpatients. Hyponatremia could be a predictive factor of both illness and worse-prognosis.