Mortality in a Clostridium sordellii Case Series

Clostridium sordellii (C sordellii) is a gram positive, anaerobic bacterium that causes severe, often fatal infections. Classically, C sordellii infection is described as a high mortality process for women of childbearing age. We examined C sordellii infections in our hospital to determine if there have been any changes in prevalence, treatment, or outcome.

We performed a query review of all patients with positive cultures for any type of Clostridium from 2007 to 2022. Individual charts were then reviewed for culture data. Data was analyzed using descriptive statistics, while comparison between the patients that lived compared to those who died was analyzed using a student's t-test.

A total of 15 patients had culture results positive for C sordellii. Interestingly, five patients had a C sordellii microbiology result without clinical evidence of soft tissue infection, suggesting colonization. Of the remaining ten patients with soft tissue infections, eight (80%) had a known history of intravenous drug use. All four patients who died presented with hypotension and markedly elevated WBCs. All four who died had a known history of intravenous drug use.

To date, we believe this is the largest case series of C sordellii infections at a single institution. Our findings suggest that C sordellii may be more common in the environment that previously reported. Determining what makes this bacterium deadly to some, but not to others, requires further research. We must remain vigilant in evaluation of C sordellii infections to improve patient survival.