Epidemiology and clinical features of toxigenic culture-confirmed hospital-onset Clostridium difficile infection: a multicentre prospective study in tertiary hospitals of South Korea
Han, Sang Hoon and Kim, Heejung and Lee, Kyungwon and Jeong, Su Jin and Park, Ki-Ho and Song, Joon Young and Seo, Yu Bin and Choi, Jun Yong and Woo, Jun Hee and Kim, Woo Joo and Kim, June Myung,, 63, 1542-1551 (2014),
doi = https://doi.org/10.1099/jmm.0.070672-0,
publicationName = Microbiology Society,
issn = 0022-2615,
abstract= Hypervirulent Clostridium difficile strains, most notably BI/NAP1/027, have been increasingly emerging in Western countries as local epidemics. We performed a prospective multicentre observational study from December 2011 to May 2012 to identify recent incidences of toxigenic culture-confirmed hospital-onset C. difficile infections (CDI) and their associated clinical characteristics in South Korea. Patients suspected of having been suffering from CDI more than 48 h after admission and aged ≥20 years were prospectively enrolled and provided loose stool specimens. Toxigenic C. difficile culture (anaerobic culture+toxin A/B/binary gene PCR) and PCR ribotyping were performed in one central laboratory. We enrolled 98 toxigenic culture-confirmed CDI-infected patients and 250 toxigenic culture-negative participants from three hospitals. The incidence of toxigenic culture-confirmed hospital-onset CDI cases was 2.7 per 10 000 patient-days. The percentage of severe CDI cases was relatively low at only 3.1 %. UK ribotype 018 was the predominant type (48.1 %). There were no hypervirulent BI/NAP1/027 isolates identified. The independent risk factors for toxigenic culture-confirmed hospital-onset CDI were invasive procedure (odds ratio (OR) 7.3, P = 0.003) and past CDI history within 3 months (OR 28.5, P = 0.003). In conclusion, the incidence and severity of CDI in our study were not higher than reported in Western countries.,
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