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The incidence and clinical symptomatology of Clostridium difficile infections in a community setting in a cohort of Danish patients attending general practice

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Author

  • L. M. Soes
  • H. M. Holt
  • Blenda Böttiger
  • H. V. Nielsen
  • M. Torpdahl
  • E. M. Nielsen
  • S. Ethelberg
  • K. Molbak
  • V. Andreasen
  • M. Kemp
  • K. E. P. Olsen
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Summary, in English

Clostridium difficile infection (CDI) is gradually being recognised as a cause of morbidity in the community. We investigated the incidence and clinical characteristics of CDI in a community setting and characterised the C. difficile strains by toxin gene profiling and polymerase chain reaction (PCR) ribotyping. Patients included in the study had attended general practice, primarily because of diarrhoea; CDI patients (259 patients; 121 < 2 years of age) had positive cultures for toxigenic C. difficile and non-CDI patients (455 patients) were culture-negative. Outcome variables included the frequency and duration of diarrhoea, vomiting, stomach ache, fever > 38 A degrees C, weight loss and sick leave. Data were analysed by logistic regression. CDI patients < 2 and a parts per thousand yen2 years of age with C. difficile as the only enteropathogen in the faecal sample reported slimy stools (65 % vs. 62 %), stomach ache (60 % vs. 75 %), weight loss (50 % vs. 76 %) and duration of diarrhoea > 15 days (59 % vs. 73 %) as the predominant symptoms. CDI patients a parts per thousand yen2 years old reported duration of diarrhoea > 15 days more often compared to non-CDI patients (73 % vs. 27 %, p < 0.0001). The annual incidence of CDI was 518 and 23/100,000 for patients < 2 and a parts per thousand yen2 years of age, respectively, and 46/100,000 in the subgroup of patients a parts per thousand yen60 years of age. CDI was characterised by stomach ache and persistent diarrhoea, often leading to weight loss. This emphasises the importance of diagnosing CDI not only in hospitalised patients, but also in individuals a parts per thousand yen2 years of age attending general practice because of gastrointestinal symptoms, especially in the elderly, where the incidence of CDI is high.

Publishing year

2014

Language

English

Pages

957-967

Publication/Series

European Journal of Clinical Microbiology & Infectious Diseases

Volume

33

Issue

6

Document type

Journal article

Publisher

Springer

Topic

  • Infectious Medicine

Status

Published

Research group

  • Clinical Microbiology, Malmö

ISBN/ISSN/Other

  • ISSN: 1435-4373