Study Confirms C difficile Becoming More Deadly

Washington, DC?Deaths or colon surgeries related to infection with Clostridium difficile are becoming more common, reported Wallace Alston, MD, of the University of Vermont, and Fletcher Allen Health Care, Burlington, Vt, at the 45th Interscience Conference on Antimicrobial Agents and Chemotherapy.

Historically, only 1% to 2% of cases of C difficile have been severe (toxic megacolon) or fatal. Recent reports from the United States and Canada, however, suggest an increase in the number of severe cases, said Dr Alston.

Outcomes were examined for 867 hospitalizations at Fletcher Allen Health Care that included a confirmed diagnosis of C difficile between January 1, 2000, and December 31, 2004.

A total of 132 (15.2%) of the patients died. Compared with the baseline period (2000-2003), the case fatality rate "definitely" and "probably" due to C difficile increased from about 0.5% to >3.0% (P <.01).

The rate of definite death, probable death, or colectomy due to C difficile in?creas?ed nearly 6-fold between 2000-2003 and 2004, from 1.4% to 8.2% (P <.001).

In logistic regression analysis, ab?dominal pain, computed tomography scan showing colitis, and a diagnosis before admission were associated with a C difficile death or colectomy.

The explanation for the change in the epidemiology of C difficile requires further study, said Dr Alston.?W.K.