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Mortality related to C. difficile 2.5 times higher than controls
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SAN FRANCISCO — The mortality rate was 2.5 times higher among patients with Clostridium difficile infection compared with control patients, according to data from the Netherlands.
Although mortality rates are high during C. difficile outbreaks, there were no existing data about the mortality related to C. difficile in non-outbreak situations, study researchers said. Marjolein Hensgens, MD, a PhD candidate at the Leiden University Medical Center in the Netherlands, and colleagues conducted a study to estimate mortality of C. difficile in a non-outbreak situation.
Marjolein Hensgens
“The mortality among patients with a C. difficile infection is high, even in absence of an outbreak,” Hensgens told Infectious Disease News. “In our study, 13% of the patients with an infection due to C. difficile died within 30 days. This was 2.5 times higher than the mortality in similar control patients."
From 2006 to 2009, the researchers conducted a cohort study at 13 hospitals in the Netherlands to determine all-cause mortality and mortality related to C. difficile. It included all patients with a positive assay for C. difficile who were matched to control patients, one with diarrhea and one without. The researchers used the Dutch Civil Registration System to determine survival status.
The study included 1,366 patients with C. difficile, an incidence of 13 per 10,000 admissions. After 30 days, the all-cause mortality was 13%. After 6 months, the all-cause mortality was 30%, and after 1 year, it was 37%. There were 317 patients with C. difficile who were matched to patients without diarrhea and 232 patients with diarrhea.
Compared with the controls without diarrhea, patients with C. difficile had a 2.9-fold increased 30-day mortality. After adjusting for age, sex and underlying diseases, the risk persisted (HR=2.5; 95% CI, 1.4-4.3). Death related to C. difficile was most common within 30 days after diagnosis.
“Our study shows that C. difficile infections have a significant clinical impact and represent a serious health care associated infection,” Hensgens said. “The majority of the patients in our study was treated for a C. difficile infection, therefore, our study also highlights that novel therapeutic options are urgently needed. Mandatory reporting of C. difficile infections in healthcare facilities will help to monitor the mortality among patients with a C. difficile infection in future.”
For more information:
Hensgens M. #K-472. Presented at: 52nd ICAAC; Sept. 9-12, 2012; San Francisco.
Disclosure: Hensgens reports no relevant financial disclosures.