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Updated: Mar 13, 2026
11:13
Culturing and Maintaining Clostridium difficile in an Anaerobic Environment
Published on: September 14, 2013
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Clostridium difficile infection in dialysis patients
Ankita Tirath1, Sandra Tadros1, Samuel L Coffin1
1Department of Medicine, Augusta University, Augusta, Georgia, USA.
Summary
Clostridium difficile infection (CDI) is common in patients with end-stage renal disease (ESRD). Elderly patients, those with HIV, and bacteremia face higher infection risks and nearly double the mortality risk.
Area of Science:
- Nephrology
- Infectious Diseases
- Epidemiology
Background:
- Clostridium difficile infection (CDI) is a leading cause of hospital-acquired diarrhea.
- Patients with end-stage renal disease (ESRD) may have a heightened susceptibility to CDI.
- CDI in ESRD patients is associated with increased mortality, prolonged hospital stays, and elevated healthcare costs.
Purpose of the Study:
- To investigate the incidence of CDI in ESRD patients.
- To identify comorbidities associated with CDI in this population.
- To determine risk factors for mortality and recurrence of CDI in ESRD patients.
Main Methods:
- Utilized the United States Renal Data System (USRDS) database.
- Analyzed records of 419,875 incident dialysis patients from 2005 to 2008.
- Assessed incidence, comorbidities, recurrence, and mortality related to CDI.
Main Results:
- 4.25% of incident dialysis patients received a first CDI diagnosis.
- Hospitalization or ICU stay within 90 days prior to diagnosis was common.
- Highest adjusted relative risks for CDI included HIV (aRR 2.68), age ≥65 (aRR 1.76), and bacteremia (aRR 1.74).
- Adjusted hazard ratio for death in CDI patients was 1.80.
- Age ≥65 and cirrhosis were significant risk factors for death (aHR 2.28 and 1.76, respectively).
- Recurrence of CDI occurred in 23.6%, more frequent in Caucasians and older individuals.
Conclusions:
- CDI is a frequent complication in ESRD patients.
- Elderly individuals, patients with HIV, and those with bacteremia are at the highest risk for CDI.
- CDI significantly increases the mortality risk in ESRD patients by nearly twofold.
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