Clostridium difficile diarrhea in critically ill burned patients

Area of Science:

• Infectious Diseases
• Gastroenterology
• Critical Care Medicine

Background:

• Burn patients are susceptible to healthcare-associated infections.
• Clostridium difficile infection (CDI) is a common cause of antibiotic-associated diarrhea.
• Distinguishing CDI from other forms of diarrhea in burn patients is crucial for effective treatment.

Purpose of the Study:

• To determine the incidence of Clostridium difficile diarrhea in burn patients.
• To compare clinical characteristics of C. difficile diarrhea versus nonspecific diarrhea in this population.
• To evaluate treatment outcomes for both types of diarrhea.

Main Methods:

• Prospective follow-up of 112 patients at a University of Washington Burn Center.
• Diagnosis of C. difficile diarrhea via laboratory testing.
• Comparison of patient demographics, burn characteristics, and clinical parameters between diarrhea groups.

Main Results:

• Overall incidence of C. difficile diarrhea was 17%.
• Among patients with diarrhea, 45% had C. difficile-positive episodes.
• White blood cell count was the only significant differentiator between C. difficile and nonspecific diarrhea.
• Nonspecific diarrhea was self-limiting; C. difficile diarrhea responded to vancomycin hydrochloride in an average of 3.3 days.

Conclusions:

• Clostridium difficile diarrhea is a significant concern in burn patients.
• Elevated white blood cell count may indicate C. difficile infection.
• Vancomycin is an effective treatment for C. difficile diarrhea in burn patients, with a low recurrence rate.