Clinical characteristics of Clostridium difficile-associated diarrhea among patients in a tertiary care center in China

Objective: this study investigated the incidence,risk factors,and clinical characteristics of clostridium difficile-associated diarrhea (cdad) in chinese patients. methods: fecal specimens of patients with antibiotic-associated diarrhea (aad) were collected to test c. difficile toxin a and b using enzyme-linked fluorescent assay to identify cdad. by adopting a nested casecontrol design,the matched people (ratio 1:3) without aad were included as controls. results: out of 56,172 inpatients,39,882 (71.0%) used antibiotics,470 suffered from aad,and 93 were diagnosed with cdad. the incidence of nosocomial cdad was 166 per 100,000. the proportion of cdad in aad was 19.8%. cdad patients presented with more severe clinical manifestations and exhibited more concurrent illness. logistic regression analysis showed the risk factors of cdad: advanced age,nasogastric tube-feeding,high apache ii scores,high level of serum c-reaction protein,low level of serum albumin,severe underlining disease or comorbidity,and number of antibiotic intake. twenty-nine patients (31.2%) were cured with vancomycin,54 (58.1%) were cured after dual therapy of vancomycin plus metronidazole,7 (7.5%) died of underlying diseases aggravated with cdad,and 3 (3.2%) were transferred to other hospitals for personal reasons. conclusion: the incidence of nosocomial cdad in china was high. some risk factors could predispose cdad. � 2016,professional medical publications. all rights reserved.