1384. Incidence and Mortality Associated with Clostridium difficile Infection at a Japanese Tertiary Care Center
Session: Poster Abstract Session: Clostridium difficile
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C
  • IDSA presentation 2013 CDI .pdf (139.0 kB)
  • Background: Although increases in the incidence of Clostridium difficileinfection (CDI) have been observed in numerous countries, the incidence of CDI in Japan remains unclear. We applied internationally recognized surveillance definitions to describe the incidence of CDI at a Japanese tertiary care center.

    Methods: A retrospective single-center cohort study was performed at a 550-bed, tertiary care, academic medical center in Sapporo, Japan. Data were collected on patients with diagnosis of CDI confirmed by positive stool toxin test from September 2010 through August 2012. Cases were categorized as healthcare facility (HCF)-onset (HO) CDI, community-onset (CO) HCF-associated CDI attributed to the study hospital, CO HCF-associated CDI not attributed to a study hospital, community-associated CDI, and indeterminate CDI. Factors associated with a 30-day all-cause mortality after the completion of CDI treatment were also investigated.  

    Results: There were 32,296 admissions with 350,074 patient-days from 22,836 patients during the study period; 126 patients were diagnosed with CDI. Median age of CDI case patients was 78. Eighty five percent of CDI occurred as a HO CDI with an incidence of 3.11 cases per 10,000 patient-days. Three (2.4%) patients underwent colectomy for CDI and 19 patients (15%) died within a 30 days of CDI. Factors independently associated with a 30-day all cause mortality were diabetes mellitus [adjusted odds ratio, 4.71;95% confidence interval (CI):1.46-15.2] and shock at the diagnosis of CDI 11.8 (adjusted odds ratio, 11.8; 95% CI: 3.15-44.3).  

    Conclusion: The CDI incidence was lower than that typically reported from North American Hospitals, but the proportion of patients requiring surgical therapy and dying within 30 days of completing CDI treatment in non-outbreak settings was higher. More study is needed to determine why CDI incidence is low relative to CDI-associated outcome in Japan.

    Hitoshi Honda, MD1, Akinori Yamazaki, PharmD2, Yumiko Sato, RN, CIC2 and Erik Dubberke, MD, MSPh3, (1)Division of Infectious Diseases and Department of Infection Prevention, Tokyo Metropolitan Tama Medical Center, Fuchu, Tokyo, Japan, (2)Infection Prevention, Teine Keijinkai Medical Center, Sapporo, Japan, (3)Infectious Disease, Washington University School of Medicine, St. Louis, MO


    H. Honda, None

    A. Yamazaki, None

    Y. Sato, None

    E. Dubberke, Merk: Consultant and Investigator, Consulting fee and Research support
    Viropharma : Investigator, Research support
    Optimer: Consultant and Investigator, Consulting fee and Research support
    Pfizer : Consultant, Consulting fee
    Sanofi Pasteur: Investigator, Research support
    bioMerieux: Consultant, Consulting fee

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