Volume 16, Number 8—August 2010
CME ACTIVITY
Clostridium difficile Bacteremia, Taiwan1
Table 2
Summary of clinical characteristics of 12 patients with Clostridium difficile bacteremia in the current series from Taiwan, 1989–2009, and of 20 additional cases published since 1962*
| Characteristic | Total, n = 32 | Reported cases, n = 20 | Current series, n = 12 | p value |
|---|---|---|---|---|
| Age, y, mean ± SD | 51.4 ± 26.1 | 46.2 ± 27.5 | 59.9 ± 22.2 | 0.14 |
| Elderly, age >60 y | 18 (56.3) | 11 (55.0) | 7 (58.3) | 1.0 |
| Male |
19 (59.4) |
14 (70.0) |
5 (41.7) |
0.15 |
| Place of acquisition | 0.70 | |||
| Community | 12/28 (42.9) | 5/16 (73.3) | 7 (58.3) | |
| Hospital |
16/28 (57.1) |
11/16 (26.7) |
5 (41.7) |
|
| Calendar year range | 0.001 | |||
| 1962–1990 | 8 (25) | 8 (40.0) | 0 | |
| 1991–2000 | 8 (25) | 7 (35.0) | 1 (8.3) | |
| After 2000 |
16 (50) |
5 (25.0) |
11 (91.7) |
|
| Comorbidity | ||||
| Malignancy | 9 (28.1) | 6 (30.0) | 3 (25.0) | 1.0 |
| Congestive heart failure | 4 (12.5) | 3 (15.0) | 1 (8.3) | 1.0 |
| Immunosuppression | 7 (21.9) | 2 (10.0) | 5 (41.7) | 0.07 |
| Chronic obstructive pulmonary disease | 3 (9.4) | 2 (10.0) | 1 (8.3) | 1.0 |
| Chronic kidney disease | 3 (9.4) | 1 (5.0) | 2 (16.7) | 0.54 |
| Liver cirrhosis | 7 (21.9) | 1 (5.0) | 6 (50.0) | 0.006 |
| Cerebrovascular accident | 2 (6.3) | 1 (5.0) | 1 (8.3) | 1.0 |
| Diabetes mellitus | 4 (12.5) | 0 | 4 (33.3) | 0.014 |
| Organ transplant | 2 (6.3) | 0 | 2 (16.6) | 0.13 |
| None |
6 (18.8) |
6 (30.0) |
0 |
0.06 |
| Clinical signs and symptoms | ||||
| Fever | 19/27 (70.4) | 10/15 (66.7) | 9 (75.0) | 0.70 |
| Abdominal pain | 14/29 (48.3) | 8/17 (47.1) | 6 (50.0) | 1.0 |
| Diarrhea |
12/28 (42.9) |
8/16 (50.0) |
4 (33.3) |
0.46 |
| Gastrointestinal disease or condition | 10/28 (35.7) | 5/16 (31.3) | 5 (41.7) | 0.7 |
| Gastrointestinal bleeding | 5/27 (18.5) | 0/15 (0.0) | 5 (41.7) | 0.01 |
| Gastrointestinal perforation | 3/28 (10.7) | 2/16 (12.5) | 1 (8.3) | 1.0 |
| Pseudomembranous colitis |
5/27 (18.5) |
3/15 (20.0) |
2 (16.7) |
1.0 |
| Recent antimicrobial drug exposure |
18/26 (69.2) |
13/14 (92.9) |
5 (41.7) |
0.009 |
| Sources of bacteremia | ||||
| Primary | 17 (53.1) | 10 (50.0) | 7 (58.3) | 0.73 |
| Intraabdominal infection | 11 (34.4) | 7 (35.0) | 4 (33.3) | 1.0 |
| Urosepsis | 2 (6.3) | 2 (10.0) | 0 | 0.52 |
| Skin and soft tissue infection | 2 (6.3) | 1 (5.0) | 1 (8.3) | 1.0 |
| Bone and joint infection | 1 (3.1) | 0 | 1 (8.3) | 0.38 |
| Polymicrobial bacteremia |
20 (62.5) |
14 (70.0) |
6 (50.0) |
0.29 |
| Positive clostridial toxin assay result | 14/22 (63.6) | 9/12 (75.0) | 5/10 (50.0) | 0.42 |
| Crude death rate | 15/31 (48.4) | 10/19 (52.6) | 5 (41.7) | 0.72 |
*Values are no. patients (%) or no. patients/total no. patients evaluated (%), except for age. Patients may have >1 morbidity, clinical sign or symptom, and gastrointestinal disease or condition.
