Epidemiology and clinical features of toxigenic culture-confirmed hospital–onset Clostridium difficile infection: A multicentre prospective study in tertiary hospitals of South Korea

Sang Hoon Han, Heejung Kim, Kyungwon Lee, Su Jin Jeong, Ki Ho Park, Joon-Young Song, Yu Bin Seo, Jun Yong Choi, Jun Hee Woo, Woo Joo Kim, June Myung Kim

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Hypervirulent Clostridium difficile strains, most notably BI/NAP1/027, have been increasingly emerging in Western countries as local epidemics. We performed a prospective multicentre observational study from December 2011 to May 2012 to identify recent incidences of toxigenic culture-confirmed hospital-onset C. difficile infections (CDI) and their associated clinical characteristics in South Korea. Patients suspected of having been suffering from CDI more than 48 h after admission and aged ≥ 20 years were prospectively enrolled and provided loose stool specimens. Toxigenic C. difficile culture (anaerobic culture+toxin A/B/binary gene PCR) and PCR ribotyping were performed in one central laboratory. We enrolled 98 toxigenic cultureconfirmed CDI-infected patients and 250 toxigenic culture-negative participants from three hospitals. The incidence of toxigenic culture-confirmed hospital-onset CDI cases was 2.7 per 10 000 patient-days. The percentage of severe CDI cases was relatively low at only 3.1%. UK ribotype 018 was the predominant type (48.1%). There were no hypervirulent BI/NAP1/027 isolates identified. The independent risk factors for toxigenic culture-confirmed hospital-onset CDI were invasive procedure (odds ratio (OR) 7.3, P50.003) and past CDI history within 3 months (OR 28.5, P50.003). In conclusion, the incidence and severity of CDI in our study were not higher than reported in Western countries.

Original languageEnglish
Article number070672
Pages (from-to)1542-1551
Number of pages10
JournalJournal of Medical Microbiology
Publication statusPublished - 2014 Nov 1


ASJC Scopus subject areas

  • Microbiology
  • Microbiology (medical)

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