Prevalence Of Clostridium Difficile Infection Research Articles

C. difficile Infection: Changing Epidemiology and Management Paradigms.

The incidence of Clostridium difficile infection (CDI) has been rising in hospitals, long-term care facilities, and within the community. Cases have been more severe with more complications, deaths, and higher healthcare-associated costs. With the emergence of a hypervirulent strain of C. difficile and the increasing prevalence of community-acquired CDI among healthy patients without traditional risk factors, the epidemiology of C. difficile has been evolving. This changing epidemiology requires a change in management. Taking into account new risk factors for CDI and growing subpopulations of affected individuals, diagnostic, treatment, and prevention approaches need to be adjusted.

Prevalence of Clostridium difficile infection among solid organ transplant recipients: a meta-analysis of published studies.

Several factors including antibiotic use, immunosuppression and frequent hospitalizations make solid organ transplant (SOT) recipients vulnerable to Clostridium difficile infection (CDI). We conducted a meta-analysis of published studies from 1991-2014 to estimate the prevalence of CDI in this patient population. We searched PubMed, EMBASE and Google Scholar databases. Among the 75,940 retrieved citations, we found 30 studies coded from 35 articles that were relevant to our study. Based on these studies, we estimated the prevalence of CDI among 21,683 patients who underwent transplantation of kidney, liver, lungs, heart, pancreas, intestine or more than one organ and stratified each study based on the type of transplanted organ, place of the study conduction, and size of patient population. The overall estimated prevalence in SOT recipients was 7.4% [95%CI, (5.6-9.5%)] and it varied based on the type of organ transplant. The prevalence was 12.7% [95%CI, (6.4%-20.9%)] among patients who underwent transplantation for more than one organ. The prevalence among other SOT recipients was: lung 10.8% [95% CI, (5.5%-17.7%)], liver 9.1 % [95%CI, (5.8%-13.2%)], intestine 8% [95% CI, (2.6%-15.9%)], heart 5.2% [95%CI, (1.8%-10.2%)], kidney 4.7% [95% CI, (2.6%-7.3%)], and pancreas 3.2% [95% CI, (0.5%-7.9%)]. Among the studies that reported relevant data, the estimated prevalence of severe CDI was 5.3% [95% CI (2.3%-9.3%)] and the overall recurrence rate was 19.7% [95% CI, (13.7%-26.6%)]. In summary, CDI is a significant complication after SOT and preventive strategies are important in order to reduce the CDI related morbidity and mortality.

Uncovering the role of antibiotics in the transmission of multidrug-resistant organisms.

Uncovering the role of antibiotics in the transmission of multidrug-resistant organisms.

Testing for Clostridium difficile in patients newly diagnosed with inflammatory bowel disease in a community setting.

The incidence of Clostridium difficile infection (CDI) in inflammatory bowel disease (IBD) is increasing, and CDI has a negative impact on IBD outcomes with both increased morbidity and mortality. Data are lacking regarding the rate of appropriate testing for CDI at the time of diagnosis. We sought to determine the rate of CDI testing and CDI positivity at diagnosis of IBD using data collected through the Ocean State Crohn's and Colitis Area Registry (OSCCAR), a prospective cohort of patients with newly diagnosed IBD. CDI testing and CDI positivity were determined by reviewing the medical records of patients enrolled into the registry and diagnosed with IBD between January 2008 and July 2011. Of 320 enrolled patients, 227 (70.9%) reported diarrhea, and CDI testing was performed for 113 (49.8%) of the 227 patients. CDI testing was not recorded as being performed for the remaining 114 patients who reported having diarrhea. An additional 24 patients were tested for CDI but did not report having diarrhea. Seven (5.1%) of the 137 patients tested for CDI were positive. Testing for CDI is significantly lower than expected at diagnosis of IBD. Although the prevalence of CDI among tested patients is approximately 5%, a low testing rate suggests a significant quality issue in the diagnosis of IBD, with the potential for delayed diagnosis of CDI.

Seek and you shall find: Prevalence of Clostridium difficile in Wuhan, China

Clostridium difficile infection (CDI) is one of the leading health care acquired-infections in the United States, but much of the epidemiology and burden of disease is unknown in China. The aim of this study was to determine the prevalence and possible risk factors of CDI among hospitalized patients with diarrhea in Wuhan, China. The overall prevalence of CDI was 28% (31/111). The findings of this study suggest the prevalence of CDI in hospitalized patients with diarrhea is higher then what has been previously reported in the current literature.

Prevalence of Clostridium difficile infections among hospitalized patients in Amman,Jordan: A Multi-Center Study

Clostridium diffiile is a Gram-positive endospore-forming bacillus that was discovered as a bowel colonizer and pathogen in 1935. Healthy newborns and infants were found to be colonized with C. diffiil eat rates ranging from 45 to 70%. However, the prevalence of toxigenic strains was found to be as low as 13%. The colonization rates decline as individuals grow older, reaching rates lower than 5% in urban-dwelling healthy adults. However, colonization rates as high as 25-55% has been detected among adult hospitalized patientsand nursing home residents

The epidemiology and economic burden of Clostridium difficile infection in Korea.

The prevalence of Clostridium difficile infection and the associated burden have recently increased in many countries. While the main risk factors for C. difficile infection include old age and antibiotic use, the prevalence of this infection is increasing in low-risk groups. These trends highlight the need for research on C. difficile infection. This study pointed out the prevalence and economic burden of C. difficile infection and uses the representative national data which is primarily from the database of the Korean Health Insurance Review and Assessment Service, for 2008–2011. The annual economic cost was measured using a prevalence approach, which sums the costs incurred to treat C. difficile infection. C. difficile infection prevalence was estimated to have increased from 1.43 per 100,000 in 2008 to 5.06 per 100,000 in 2011. Moreover, mortality increased from 69 cases in 2008 to 172 in 2011. The economic cost increased concurrently, from $2.4 million in 2008 to $7.6 million, $10.5 million, and $15.8 million in 2009, 2010, and 2011, respectively. The increasing economic burden of C. difficile infection over the course of the study period emphasizes the need for intervention to minimize the burden of a preventable illness like C. difficile infection.

What's the Clinical Features of Colitis in Elderly People in Long-Term Care Facilities?

Background/AimsAs life expectancy has increased, the number of elderly patients who need long-term care has grown rapidly. Mortality in patients with colitis in long-term care facilities (LTCFs) is increasing. We intend to investigate the main causes of colitis in LTCFs compared to those of colitis in local communities, and to identify the clinical features and risk factors of patients with colitis in LTCFs.MethodsWe retrospectively analyzed epidemiology, medical conditions, laboratory values, diagnoses, and clinical courses of elderly patients aged ≥65 who were admitted to the Ewha Womans University hospital with colitis between January 2007 and July 2012.ResultsPatients with colitis in LTCFs (n=20) were compared with elderly patients with colitis in local communities (n=154). Fifty-five percent of colitis in LTCFs was caused by Clostridium difficile infection (CDI), 30% was due to ischemic colitis, and 15% was due to non-specific colitis. Non-specific colitis was the most common (63%) in the community group. Clinical outcomes were also significantly different between both groups: higher mortality (10.0% vs. 0.64%, P=0.021), higher requirement for intensive care units care (50.0% vs. 18.8%, P<0.01) in LTCFs group. In univariate analysis, the most significant risk factor for death in patients in LTCFs was decreased mental faculties.ConclusionsPatients in LTCFs showed worse clinical outcomes and a much higher prevalence of CDI compared to patients from local communities. We suggest early and active evaluation, such as endoscopic examination, for differential diagnosis in patients in LTCFs.

Evaluation of Real Time Polymerase Chain Reaction and Enzyme Immunoassay in Diagnosis of Clostridium Difficile Infection

Background: Clostridium difficile infection (CDI) is the most common cause of antibiotic associated diarrhea (AAD). Rapid diagnosis of CDI is essential to prevent hospital spread of infection. Objectives: The aim of this work were to determine the prevalence of CDI among cases of AAD in Zagazig University Hospitals, identify risk factors, and evaluate real-time polymerase chain reaction (PCR) and enzyme immunoassay (EIA), against toxigenic culture (TC). Methodology: Stools were collected from 150 patients with AAD. Results: They were tested for TC, toxin A/B EIA, and C. difficile tcdA/tcdB genes. Thirty four toxigenic C. difficile isolates were obtained (22.7%) out of the 150 patients and those patients were considered positive for CDI. On the other hand, 6 non-toxigenic C. difficile isolates were obtained (4%), while culture of the remaining 110 patients (73.3%) did not yield C. difficile. The later 116 patients (77.3%) were considered negative for CDI. Analysis of risk factors revealed that advanced age, prolonged hospitalization, long duration of antibiotic intake, potentiated penicillins, 3 rd generation cephalosporins, antibiotic combined therapy, liver cirrhosis, malignancy, proton pump inhibitors, enteral tube feeding, and cancer chemotherapy were significantly associated with CDI. Sensitivitiy, specificitiy, positive predictive value, negative predictive value, and accuracy of real-time PCR against TC were all 100%, however, values of EIA were 79.4%, 100%, 100%, 94.3%, 95.3%, respectively. Conclusions: CDI is an underappreciated nosocomial infection predisposed by many risk factors. Real-time PCR proved superior diagnostic performance to toxin A/B EIA.

1028The Prevalence of Clostridium difficile Infection (CDI) is Highly Correlated with the Prevalence of Surgical Site Infection (SSI)

1028The Prevalence of Clostridium difficile Infection (CDI) is Highly Correlated with the Prevalence of Surgical Site Infection (SSI)

Prevalence of Clostridium difficile infection presenting to US EDs

ObjectiveThe objective of the study is to determine the prevalence of Clostridium difficile infection (CDI) presenting to emergency departments (EDs) in the United States. Secondary objectives included defining the burden of CDI. MethodsThis is a retrospective, observational cohort study of 2006-2010 Nationwide Emergency Department Sample database of 980 US hospital EDs in 29 states. Prevalence, mortality rate, length of stay, hospital charges, and endemicity were measured. ResultsA total of 474513 patients with CDI-related ED visits were identified. From 2006 to 2010, the prevalence of CDI increased from 26.2 to 33.1 per 100000 population (P < .001). The number of CDI-related ED cases increased 26.1% (P < .001) over the study period: 18.6% from 2006 to 2007 (P < .001), 4.3% from 2007 to 2008 (P = .46), 1.8% from 2008 to 2009 (P = .73), and 0.13% from 2009 to 2010 (P = .95). Emergency department visits occurred more frequently with individuals 85 years or older (relative risk [RR], 13.74; P < .001), females (RR, 1.77; P < .001) and in the northeast United States (RR, 1.42; P < .001). From 2009 to 2010, the mortality rate decreased 17.9% (P = .01). ConclusionsThe prevalence of CDI presenting to EDs increased each year from 2006 to 2010; however, the rate of increase slowed from each year to the next. The mortality rate increased from 2006 to 2009 and decreased significantly from 2009 to 2010. C difficile infection visits presenting to EDs occurred more frequently with older individuals, females, and in the northeast.

PIN71 - Cost-Effectiveness of Fecal Microbiota Transplant in Treating Clostridium Difficile Infection in Canada

PIN71 - Cost-Effectiveness of Fecal Microbiota Transplant in Treating Clostridium Difficile Infection in Canada

Outcomes for Severe Complicated Clostridium difficile Infection Treated with Vancomycin Enemas

Introduction: The prevalence of Clostridium difficile infection (CDI) is increasing. Serious, complicated infections have been linked to a virulent strain (BI/NAP1), which produces elevated levels of toxin and can lead to colectomy or death. For these infections, standard of care is now concomitant treatment with IV metronidazole (IVM) and per oral vancomycin (POV). Some institutions use add-on therapy with vancomycin per rectum (VPR) to increase colonic drug delivery when there is a concern about delayed transit. Our purpose was to look at clinical outcomes of consecutive patients with CDI treated with VPR at our hospital. Methods: Using pharmacy records and manual chart review, we identified inpatients prescribed VPR from 1/2003 to 12/2013. Included patients had diarrhea, a positive stool test for Clostridium difficile toxin by ELISA, and no alternative cause for symptoms. Patients were required to have been in the ICU at the initiation of treatment and to have received ≥4 doses of VPR. Patients were followed to discharge or death. Results: We identified 43 CDI patients who received VPR during the study period. We excluded 18 patients because they did not receive ≥4 doses of VPR and 1 patient who received VPR after colonic surgery. There were 11 males and 13 females, mean age was 61.8±15.9 years (range: 21-93). The dose of VPR (IV solution mixed in 100 cc of tap water) ranged from 125 to 250 mg Q 6-8 hrs. Most patients received concomitant therapy with POV (n=17) and/or IVM (n=20). Four patients (16.7%) underwent colectomy and 3 died post-op. Mortality was 11/24 (45.8%) including the 3 post-op deaths. The mean number of doses of VPR in those who survived versus died was 22.3±6.9 vs. 19.3±19.4 (P=0.62). Similarly, there were no significant differences (all P>0.05) in age (64.5±16.7 vs. 59.1±15.3 years), WBC (24.6±11.5 vs. 25.7±17.9K), or interval rise in creatinine (91.6% vs. 100%) between those who survived versus died or those who survived versus the combined endpoint of surgery/death. There was notably a shorter median time interval between initiation of CDI treatment and initiation of VPR for those who survived and avoided surgery (3.5 days; IQR 1-15.25 vs. 8.5 days; IQR 2-19.5), but this was not statistically significant (P=0.47). Conclusion: In our study, the largest case series reported to date on the use of VPR for severe, complicated CDI, 50.0% of patients ultimately died or had a colectomy. Based on our modest sample size and high rate of morbidity and mortality we cannot strongly advocate for the use of VPR at this time. It appeared that earlier initiation of VPR may be beneficial. Controlled trials are needed to better assess this therapy.

Polymerase chain reaction ribotyping of Clostridium difficile isolates in Qatar: a hospital-based study.

BackgroundClostridium difficile infection (CDI) is not generally reported to public health authorities in the Middle East and its true prevalence remains largely unknown. The aims of this study were to determine the prevalence of CDI and its associated ribotypes among C. difficile isolates in Qatar. Influence of age and correlation with other risk factors e.g. proton pump inhibitor use, antibiotic use, existence of chronic conditions, etc was also investigated for CDI positive patients.MethodsA total of 1,532 patients with suspected CDI were recruited from two hospitals between 2011 and 2012. C. difficile was identified using glutamate dehydrogenase (GDH) lateral flow assay and toxins A and B Enzyme Immunoassay (EIA). The C. difficile positive samples were then cultured for PCR-ribotyping.Results122 of the 1,532 (7.9%) samples from individual patients were identified as C.difficile positive; and 79 of these were viably cultured (~65%). From these, 36 different PCR ribotypes were isolated, of which strains 258 (6 [7.6%]), 01/014/046 (5 [6.3%]), and 011/053/056/107 (4 [5%]) were the most prevalent. The prevalence of PCR-ribotype 027 was 1.3% (n = 1). An age of ≥65 years and treatment with proton pump inhibitors correlated with higher frequency of CDI. Treatment with third generation cephalosporins (50 [41%]) and piperacillin/tazobactam antibiotics (55 [45.1%]) was most frequently associated with CDI.ConclusionThe most common C. difficile ribotype identified in Qatar was 258, which is different from those found in North America, Europe and Asia. The prevalence of CDI was higher in Qatar than Europe; though comparable to other Middle Eastern countries. These findings underscore the importance of local surveillance to detect and control C. difficile infection.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2334-14-502) contains supplementary material, which is available to authorized users.

Clostridium difficile infection after cardiac surgery: Prevalence, morbidity, mortality, and resource utilization

Despite increasing efforts to prevent infection, the prevalence of hospital-associated Clostridium difficile infections (CDI) is increasing. Heightened awareness prompted this study of the prevalence and morbidity associated with CDI after cardiac surgery. A total of 22,952 patients underwent cardiac surgery at Cleveland Clinic from January 2005 to January 2011. CDI was diagnosed by enzyme immunoassay for toxins and, more recently, polymerase chain reaction (PCR) testing. Hospital outcomes and long-term survival were compared with those of the remaining population in propensity-matched groups. One hundred forty-five patients (0.63%) tested positive for CDI at a median of 9 days postoperatively, 135 by enzyme immunoassay and 11 by PCR. Its prevalence more than doubled over the study period. Seventy-seven patients (48%) were transfers from outside hospitals. Seventy-three patients (50%) were exposed preoperatively to antibiotics and 79 (56%) to proton-pump inhibitors. Patients with CDI had more baseline comorbidities, more reoperations, and received more blood products than patients who did not have CDI. Presenting symptoms included diarrhea (107; 75%), distended abdomen (48; 34%), and abdominal pain (27; 19%). All were treated with metronidazole or vancomycin. Sixteen patients (11%) died in hospital, including 5 of 10 who developed toxic colitis; 3 of 4 undergoing total colectomy survived. Among matched patients, those with CDI had more septicemia (P < .0001), renal failure (P = .0002), reoperations (P < .0001), prolonged postoperative ventilation (P < .0001), longer hospital stay (P < .0001), and lower 3-year survival, 52% versus 64% (P = .03), than patients who did not have CDI. Although rare, the prevalence of CDI is increasing, contributing importantly to morbidity and mortality after cardiac surgery. If toxic colitis develops, mortality is high, but colectomy may be lifesaving.

Clostridium difficile Infection in Liver Transplant Recipients: A Retrospective Study of Rates, Risk Factors and Outcomes

Clostridium difficile infection (CDI) occurs in 3-7% of liver transplant recipients (LTR). However, few data exist on the recent epidemiology, predictors and outcomes of CDI in LTR. A cohort study was performed including LTR from 2000 to 2010 at a tertiary care hospital in Detroit. CDI was defined as diarrhea with a stool C. difficile positive test. Data analyzed included demographics, comorbidities, length of stay (LOS), severity of CDI, rates of recurrence (<12 weeks), relapse (<4 weeks) and overall mortality. Predictors of CDI were calculated using Cox proportional hazard model; 970 LTR were followed for years. Overall prevalence of CDI was 18.9%. Incidence of CDI within 1 year of transplant was 12.4%. Severe CDI occurred in 29.1%. CDI recurrence and relapse rates were 16.9% and 9.7%, respectively. Independent predictors of CDI were year of transplant (hazard ratio [HR] 1.137, 95% confidence interval [CI] 1.06-1.22; p < 0.001), white race (105/162 whites, HR 1.47, 95% CI 1.03-2.1; p = 0.035), Model for End-Stage Liver Disease score (HR 1.03, 95% CI 1.01-1.045, p = 0.003) and LOS (HR 1.01, 95% CI 1.005-1.02, p < 0.001). Significant mortality was observed among LTR with CDI compared to those without CDI (p = 0.003). We concluded that CDI is common among LTR and is associated with higher mortality.

The Prevalence of Clostridium difficile Infection in a Cohort of Sri Lankan Patients with Acute Severe Ulcerative Colitis

Introduction: Global studies report that 5%-19% of patients with acute severe ulcerative colitis (ASUC) are positive for Clostridium difficile. Data from Sri Lanka, as well as from other countries in South Asia are lacking. Guidelines recommend all patients with ASUC be tested for Clostridium difficile in stools. The implications of this on developing countries such as ours are a higher cost to patients. Therefore in this study we sort to find out the prevalence of Clostridium difficile infection in patients with ASUC presenting to a teaching hospital over an eighteen month period. Method: All ulcerative colitis (histologically proven) patients admitted with ASUC from July 2011 to December 2012 were included. ASUC was diagnosed according to True love and Witt's criteria. A Clostridium difficile infection was diagnosed based on the ELISA test to detect Clostridium difficile toxins, done on a single sample of stools within 24 hours of admission. Results and discussion: 32 patients; with ASUC were included. Six (18.75%) tested positive for Clostridium difficile. The mean age was 28 and 48 years in the positive and negative group respectively. Of the positive patients three were previously on Aminosalicylates and three were treatment naive. Apart from one patient with a history of recent antibiotic use, none of the other patients gave a history of antibiotic, PPI use or hospital admission within 3 months. The White blood cell count, ESR or stools full report were unable to predict the presence of Clostridium difficile infection. Apart from one patient with pseudo-membranes on endoscopy, none of the other toxin positive patient's endoscopy or histology was suggestive of Clostridium difficile infection. Conclusion: This study shows a high prevalence of Clostridium difficile infection among Sri Lankan patients presenting with ASUC, which is in keeping with studies reported previously. Although local or regional guidelines are lacking, this study also reconfirms the necessity to test for Clostridium difficile in ASUC. As suggested by previous authors the risk factors associated with the development of Clostridium difficile infections in ASUC seems different to the general population.

PIN100 - OUTCOMES AND EXPENDITURES OF CLOSTRIDIUM DIFFICILE INFECTION IN PEDIATRIC SOLID ORGAN TRANSPLANT RECIPIENTS

PIN100 OUTCOMES AND EXPENDITURES OF CLOSTRIDIUM DIFFICILE INFECTION IN PEDIATRIC SOLID ORGAN TRANSPLANT RECIPIENTS Ling Y.L., Rascati K.L. The University of Texas at Austin, College of Pharmacy, Austin, TX, USA objeCtives: To assess outcomes of clostridium difficile infection (CDI) and the association of expenditures and CDI in pediatric solid organ transplant (SOT) recipients. Methods: Data from the 2000, 2003, 2006, and 2009 Kids’ Inpatient Database (KID) files were used to identify events with SOTrelated ICD-9-CM diagnosis codes. The data were evaluated using logistic regressions and log-linked gamma regressions. Results: The total number of pediatric SOT hospital events was 48,286. The overall prevalence of CDI for pediatric SOT hospitalizations was 1.76%. For SOT hospitalizations with CDI, inpatient mortality was 1.63%; the prevalence of transplant failure or rejection events was 27.71%; the prevalence of a colectomy was 4.86%. The median LOS was seven days; the median charge for each hospitalization was $48,409; and the median cost for each hospitalization was $17,412. The results showed that CDI was not significantly associated with inpatient mortality or transplant failure/ rejection in pediatric SOT hospitalizations, but the power to detect differences was low. SOT patients with CDI were 2.6 times more likely to have a colectomy than SOT patient without CDI (OR= 2.62, 95% CI= [1.63, 4.22], p< 0.001). The mean LOS for a SOT admission with CDI was approximately 2 times the mean LOS for a SOT admission without CDI (coefficient= 1.93, 95% CI= [1.68, 2.21], p< 0.001). The mean charges and the mean costs for a SOT admission with CDI was approximately 2 times that for a SOT admission without CDI (charges: coefficient= 2.01, 95% CI= [1.63, 2.46], p< 0.001; costs: coefficient= 1.96, 95% CI= [1.50, 2.58], p< 0.001). ConClusions: CDI diagnoses were not significantly associated with higher inpatient mortality or transplant failure/ rejection for pediatric SOT hospitalizations. But CDI was significantly associated with a higher prevalence of a colectomy, longer hospital LOS, higher charges, and higher costs.

Effects of Clostridium difficile Infection in Patients With Alcoholic Hepatitis

Infection increases mortality in patients with alcoholic hepatitis (AH). Little is known about the association between Clostridium difficile infection (CDI) and AH. We examined the prevalence and effects of CDI in patients with AH, compared with those of other infections. We performed a cross-sectional analysis using data collected from the Nationwide Inpatient Sample, from 2008 through 2011. International Classification of Diseases, 9th revision, Clinical Modification codes were used to identify patients with AH. We used multivariable logistic regression to determine risk factors that affect mortality, negative binomial regression to evaluate the effects of CDI on predicted length of stay (LOS), and Poisson regression to determine the effects of CDI on predicted hospital charges. Chi-square and Wilcoxon rank-sum analyses were used to compare mortality, LOS, and hospital charges associated with CDI with those associated with urinary tract infection (UTI) and spontaneous bacterial peritonitis (SBP). Of 10,939 patients with AH, 177 had CDI (1.62%). Patients with AH and CDI had increased odds of inpatient mortality (adjusted odds ratio, 1.75; P = .04), a longer predicted LOS (10.63 vs 5.75 d; P < .001), and greater predicted hospital charges ($36,924.30 vs $29,136.58; P < .001), compared with those without CDI. Compared with UTI, CDI was associated with similar mortality but greater LOS (9 vs 6 d; P < .001) and hospital charges ($45,607 vs $32,087; P < .001). SBP was associated with higher mortality than CDI (17.3% vs 10.1%; P = .045), but similar LOS and hospital charges. In patients with AH, CDI is associated with greater mortality and health care use. These effects appear similar to those for UTI and SBP. We propose further studies to determine the cost effectiveness of screening for CDI among patients with AH.

地方中核病院における&lt;I&gt;Clostridium difficile&lt;/I&gt;感染症の発生頻度とその関連因子

Clostridium difficile（CD）感染症の発症率，臨床的背景について検討した．対象は2年3ヵ月間に施行した抗菌薬投与中の発熱および下痢を認める患者のうち便中毒素検査施行し陽性となった103例．CDtoxin発生率は年内入院患者数あたり72.5/10万人であった．平均年齢83.4歳であり，死亡数は13人（12.6％）で再発例は16人（15.5％）であった．抗菌薬投与連続2剤以上かつ長期間使用例での発生率は48.6例/10万人，その他の投与方法での発生率は23.9例/10万人であり，長期多剤の発生率は高率であった．また臨床的背景としては，長期臥床者84人（81.6％）で，最も多く認めた．また103例中で内視鏡と対比できた患者が30例あり，その有所見者は21人で70.0％であった．以上より当院におけるCD発生率は比較的高率で，長期臥床，抗菌薬の多剤長期間使用がその誘因と考えられた．また，確定診断に内視鏡検査が有用であった．