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Community-acquired Clostridium difficile infection

L Kyne¹, C Merry, B O'Connell

¹Department of Medicine for the Elderly, St. James's Hospital, Dublin, Ireland.

The Journal of Infection

|November 20, 1998

Summary

Clostridium difficile-associated disease (CDAD) is usually hospital-acquired. This study investigated a CDAD outbreak where community-acquired cases, including those solely requiring hospitalization, were identified.

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Area of Science:

Infectious Diseases
Microbiology
Epidemiology

Background:

Clostridium difficile-associated disease (CDAD) is predominantly a nosocomial infection.
Community-acquired CDAD is considered rare, with minimal hospitalization rates.

Purpose of the Study:

To report on a significant outbreak of CDAD occurring over a six-month period.
To investigate the occurrence of community-acquired CDAD during the outbreak.

Main Methods:

Retrospective analysis of 139 patients diagnosed with CDAD between January and June 1995.
Monitoring of new admissions for C. difficile cytotoxin B positive diarrhea.

Main Results:

A total of 139 patients were involved in the CDAD outbreak.

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Four deaths were attributed to pseudomembranous colitis.

A notable number of new admissions presented with C. difficile cytotoxin B positive diarrhea, sometimes as the primary reason for hospitalization.

Conclusions:

The outbreak highlighted a higher incidence of CDAD than typically observed.
The findings suggest community acquisition of CDAD may be underestimated, even leading to hospitalization.