Program Schedule

Clinical Characteristics of Relapses AND Reinfections in Clostridium difficile Infection 

Session: Poster Abstract Session: Clostridium difficile Infection: Epidemiology, Presentation, Treatment
Saturday, October 11, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
Background: The purpose of this study was to identify factors associated with relapses or reinfections in patients with recurring Clostridium difficile infections (CDIs).

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.

Jieun Kim, MD1, Mi-Ran Seo1, Jung-Oak Kang, MD, PhD2, Yeonjae Kim, MD3, Seung-Pyo Hong4 and Hyunjoo Pai, MD5, (1)Div. Infectious Diseases, Hanyang University Hospital, Seoul, South Korea, (2)Div. Microbiology, Hanyang University Hospital, Seoul, South Korea, (3)Hanyang University Hospital, Seoul, South Korea, (4)Hanyang university Hospital, Seoul, South Korea, (5)Div. Infectious Diseases, Dept. of Internal Medicine, Hanyang University Hospital, Seoul, South Korea


J. Kim, None

M. R. Seo, None

J. O. Kang, None

Y. Kim, None

S. P. Hong, None

H. Pai, None

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