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A Multicenter Study of Clostridium difficile Infection—Related Colectomy, 2000—2006

Published online by Cambridge University Press:  02 January 2015

Amelia M. Kasper ,
Humaa A. Nyazee ,
Deborah S. Yokoe ,
Jeanmarie Mayer ,
Julie E. Mangino ,
Yosef M. Khan ,
Bala Hota ,
Victoria J. Fraser ,
Erik R. Dubberke  and
Centers for Disease Control and Prevention Epicenters Program
Amelia M. Kasper*
Affiliation:
Washington University School of Medicine, St. Louis, Missouri
Humaa A. Nyazee
Affiliation:
Washington University School of Medicine, St. Louis, Missouri
Deborah S. Yokoe
Affiliation:
Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
Jeanmarie Mayer
Affiliation:
University of Utah Hospital, Salt Lake City, Utah
Julie E. Mangino
Affiliation:
Ohio State University Medical Center, Columbus, Ohio
Yosef M. Khan
Affiliation:
Ohio State University Medical Center, Columbus, Ohio
Bala Hota
Affiliation:
Stroger Hospital of Cook County/Rush University Medical Center, Chicago, Illinois
Victoria J. Fraser
Affiliation:
Washington University School of Medicine, St. Louis, Missouri
Erik R. Dubberke
Affiliation:
Washington University School of Medicine, St. Louis, Missouri
*
Box 8051, 660 South Euclid, St. Louis, MO 63110 (edubberk@dom.wustl.edu)
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Abstract

Objective.

To assess Clostridium difficile infection (CDI)-related colectomy rates by CDI surveillance definitions and over time at multiple healthcare facilities.

Setting.

Five university-affiliated acute care hospitals in the United States.

Design and Methods.

Cases of CDI and patients who underwent colectomy from July 2000 through June 2006 were identified from 5 US tertiary care centers. Monthly CDI-related colectomy rates were calculated as the number of CDI-related colectomies per 1,000 CDI cases, and cases were categorized according to recommended surveillance definitions. Logistic regression was performed to evaluate risk factors for CDI-related colectomy.

Results.

In total, 8,569 cases of CDI were identified, and 75 patients underwent CDI-related colectomy. The overall colectomy rate was 8.7 per 1,000 CDI cases. The CDI-related colectomy rate ranged from 0 to 23 per 1,000 CDI episodes across hospitals. The colectomy rate for healthcare-facility-onset CDI was 4.3 per 1,000 CDI cases, and that for community-onset CDI was 16.5 per 1,000 CDI cases (P < .05). There were significantly more CDI-related colectomies at hospitals B and C (P < .05).

Conclusions.

The overall CDI-related colectomy rate was low, and there was no significant change in the CDI-related colectomy rate over time. Onset of disease outside the study hospital was an independent risk factor for colectomy.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 33 , Issue 5 , May 2012 , pp. 470 - 476
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2012

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