P0675 PREDICTORS OF MORTALITY AND MORBIDITY IN CLOSTRIDIUM DIFFICILE INFECTION

Abstract

Background Clostridium difficile (CD) is implicated in 20 to 30% of patients with antibiotic-associated diarrhoea, in 50 to 70% of those with antibiotic-associated colitis and in more than 90% of those with antibiotic-associated pseudomembranous colitis 1-4 . The incidence of CD associated diarrhoea ranges from 1 in 100 to 1 in 1,000 hospital discharges depending on the antibiotic prescribing habits of the hospital 5-7 . The consequences of CD can be severe. At one academic medical center over a three-year period, 21 of 710 cases (3%) of CD colitis required intensive care unit admission or died as a result of their infection 8 . These deaths were associated with co-morbid conditions such as malignancy, chronic obstructive pulmonary disease or renal failure and therapies such as immunosuppressive drugs, anti-peristaltic medications or the prior administration of clindamycin 9 . At another university hospital the morbidity of the infection was higher and 24 of 157 patients (15.3%) with CD colitis died from their infection 10 . The new variant of CD - which is capable of secreting much higher amounts of toxin A & B and is more resistance to standard antibiotic therapy - results in greater incidence in hospitalized patients 11 , a greater need for urgent colectomy for toxic colitis and a significantly higher mortality rate 12 . The economic consequences of CD infection can also be severe, with one report finding a mean cost of $10,970 (US$) per patient for the treatment of the infection and its complications 13 .