Hostname: page-component-78c5997874-j824f Total loading time: 0 Render date: 2024-11-10T17:10:15.411Z Has data issue: false hasContentIssue false
  • English
  • Français

A pilot study to evaluate the prevalence of malnutrition in patients with Clostridium difficile (C. diff) infection

Published online by Cambridge University Press:  23 July 2009

S. S. Wong ,
J. O'Driscoll ,
M. Weldon  and
C. Y. Yau
S. S. Wong
Affiliation:
Department of Nutrition and Dietetics, Stoke Mandeville Hospital, AylesburyHP21 8AL, UK
J. O'Driscoll
Affiliation:
Department of Microbiology, Stoke Mandeville Hospital, AylesburyHP21 8AL, UK
M. Weldon
Affiliation:
Department of Gastroenterology, Stoke Mandeville Hospital, AylesburyHP21 8AL, UK
C. Y. Yau
Affiliation:
Department of Medicine of Older People, Stoke Mandeville Hospital, AylesburyHP21 8AL, UK
Rights & Permissions [Opens in a new window]

Abstract

An abstract is not available for this content. As you have access to this content, full HTML content is provided on this page. A PDF of this content is also available in through the ‘Save PDF’ action button.
Type
Abstract
Information
Proceedings of the Nutrition Society , Volume 68 , Issue OCE1: OCE Malnutrition Matters, Joint BAPEN and Nutrition Society, 4–5 November 2008, Harrogate , 2009 , E19
Copyright
Copyright © The Authors 2009

Malnutrition is frequently reported in hospitalised adults and it is associated with significant adverse consequences in relation to health outcomes and healthcare expenditures. In 2006 the Healthcare Commission reported on C. diff outbreaks at Stoke Mandeville Hospital(1), increasing the awareness of C. diff-associated complications amongst UK hospitals. However, there is presently no data relating to the prevalence of malnutrition in patients with C. diff infection. The aims of the present study were: to establish the prevalence of malnutrition by Malnutrition Universal Screening Tool (MUST) screening(Reference Elia2, 3) in adults with C. diff infection; to carry out anthropometric measurement of BMI and albumin levels; functional assessment of handgrip (HG) strength(Reference Klidjian, Forster and Kammerling4); nutrient intake using food record chart. During 2007–8 seventy-six patients aged between 18 and 103 years admitted to a district general hospital with hospital-acquired C. diff infection were assessed after having obtained local ethics approval. The present study found that the prevalence of undernutrition was 57% (MUST 2) at the time of C. diff diagnosis. In total 26% of patients had a BMI <20 kg/m2, 87% of patients were found to have a hypoalbuminaemia (albumin <30 g/l) and 73% of patients were found to have eaten less than half their meal at the time of diagnosis. Malnourished patients (MUST 2) were found to have a significantly lower HG strength (MUST 2, 45.5% reference value v. MUST 0, 98.5% reference value; P=0.0015). No difference was found in relation to albumin levels (MUST 2, 22 g/l v. MUST 0, 22.5 g/l; P=0.34) when compared with well-nourished patients (MUST 0). The prevalence of malnutrition in patients with C. diff infection appears to be common in hospital and may be a risk factor for infection. Special attention should be given to vulnerable patients in hospital. A follow-up study with a larger sample size is underway to assess whether or not nutritional support improves patient clinical outcomes.

References

1. Health Care Commission (2006) Investigation into Outbreaks of Clostridium difficile at Stoke Mandeville Hospital, Buckinghamshire Hospitals NHS Trust. London: Health Care Commission.Google Scholar
2. Elia, M (2003) Screening for Malnutrition: A Multidisciplinary Responsibility. Development and Use of the Malnutrition Universal Screening Tool (MUST) for Adults. Redditch, Worcs.: BAPEN.Google Scholar
3. National Institute for Health and Clinical Excellence (2006) Nutrition Support in Adults: Oral Nutrition Support, Enteral Tube Feeding and Parenteral Nutrition. London: NICE.Google Scholar
4. Klidjian, AM, Forster, KJ, Kammerling, RM et al. (1980) Br Med J 281, 889–901.CrossRefGoogle Scholar