Mortality and Clostridium difficile infection: a review

Abstract

BackgroundClostridium difficile infection (CDI) is a common cause of diarrhoea in hospitalised patients. Around the world, the incidence and severity of CDI appears to be increasing, particularly in the northern hemisphere. The purpose of this integrative review was to investigate and describe mortality in hospitalised patients with CDI.MethodsA search of the literature between 1 January 2005 and 30 April 2011 focusing on mortality and CDI in hospitalised patients was conducted using electronic databases. Papers were reviewed and analysed individually and themes were combined using integrative methods.ResultsAll cause mortality at 30 days varied from 9% to 38%. Three studies report attributable mortality at 30 days, varying from 5.7% to 6.9%. In hospital mortality ranged from 8% to 37.2%ConclusionAll cause 30 day mortality appeared to be high, with 15 studies indicating a mortality of 15% or greater. Findings support the notion that CDI is a serious infection and measures to prevent and control CDI are needed. Future studies investigating the mortality of CDI in settings outside of Europe and North America are needed. Similarly, future studies should include data on patient co-morbidities.

Epidemiology of Clostridium difficile: a hospital-based descriptive study in Argentina and Mexico

“…[3][4][5][6][7][8][9][10][11] Pathogenic strains of CD produce potent toxins (e.g. toxA, toxB) that cause the clinical manifestations in humans known as symptomatic CD infection (CDI), 4,8,12,13 especially in vulnerable individuals and mostly in hospitals and long-term care facilities.…”

Anti-Infective Activities of Lactobacillus Strains in the Human Intestinal Microbiota: from Probiotics to Gastrointestinal Anti-Infectious Biotherapeutic Agents

“…difficile is a Gram-positive anaerobic bacterium that is one of the most important causes of antibiotic-associated diarrhea in the developed world, and discontinuation of antibiotics generally promotes a cure of mild infections (342). The incidence and severity of C. difficile infection appear to be on the increase, leading to significant morbidity and mortality and placing a considerable economic burden on health care systems, particularly in Europe and North America (343,344). Recent severe C. difficile disease and higher mortality rates have been associated with the emergence of strains of increased virulence, or "hypervirulent" isolates, belonging to the BI/NAP1/027 category and which are fluoroquinolone resistant (345).…”

A Review of Clostridium difficile Infection at the University Hospital of the West Indies, Jamaica

“…In a USA study, the overall mortality rate was 8.5% which remained stable over a four-year interval (9). In a review of 24 studies of CDI from North America and the United Kingdom, all-cause 30-day mortality appeared to be high, with 15 studies indicating a mortality of 15% or more (19).…”