Clinical Characteristics of Relapses AND Reinfections in Clostridium difficile Infection
Methods: From September 2008 to January 2012, cases with two or more isolates from consecutive CDI episodes were included. PCR-ribotyping and multilocus variable-number tandem-repeat analysis (MLVA) were performed using paired isolates.
Results: Among 473 patients, 68 (14.4%) experienced 1–5 recurrences. Fifty-one of these with two or more isolates from consecutive CDI episodes were included in the study; 25 (49 %) were classified as relapses and 26 (51%) as reinfections. Recurrence interval was shorter in relapse group (26.0 vs. 67.5 p=0.001), but more patients in reinfection group were hospitalized during recurrence interval (53.8% vs. 8.0%, p <0.001). Relapse rates in infections by ribotype 017, ribotype 018 and other ribotypes were 63.6%, 63.6% and 22.2%, respectively (p=0.274, p=0.069, and p=0.005). In multivariate logistic regression, infections by ribotype 017 and 018 were associated with CDI relapse (OR 4.77, 95% CI 1.02-22.31, p =0.047; OR 11.49, 95% CI 2.07-63.72, p =0.005). Conversely, admission during recurrence interval lowered relapse (OR 0.044, 95% CI 0.006-0.344, p =0.003).
Conclusion: In conclusion, relapse was more likely when infection was caused by PCR ribotype 017 and 018.
J. O. Kang, None
Y. Kim, None
S. P. Hong, None
H. Pai, None
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