| A 5-year retrospective review of experience with Clostridium difficile-associated diarrhea. | |
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MedLine Citation:
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PMID: 22594138 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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The incidence and virulence of Clostridium difficile-associated diarrhea (CDAD) has increased dramatically from the mid 1990s to the mid 2000s. This research assessed recent CDAD patterns at a major military medical center from 2005 to 2009, by retrospectively reviewing clinical data of each CDAD case identified using the center's electronic medical record system. Two hundred and thirty-two cases were identified. There was a stable incidence rate for both inpatient (2.6-4.3/1000) and outpatient (0.02-0.04/1000) infections. Overall mortality rate was 9%. Among inpatient cases, 49% were considered to be severe, with an associated mortality of 19%. Only 12% (9/77) of severe cases were treated initially with oral vancomycin, with the majority (8/9) treated in 2009. Hospitalization was a risk factor in 71% of cases, with 29% community-acquired. Other risk factors included recent antibiotic usage (83%) and proton-pump inhibitor use (60%), with 8% having no risk factors. Most cases were initially treated with metronidazole, which was associated with a 14% (27/188) recurrence rate versus 9% (2/22) treated with vancomycin (p > 0.05). In contrast to earlier reports, our center has experienced a low and stable rate of CDAD since 2005. Severe CDAD is common and associated with significant mortality. |
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Authors:
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Steven Armbruster; Lawrence Goldkind |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Military medicine Volume: 177 ISSN: 0026-4075 ISO Abbreviation: Mil Med Publication Date: 2012 Apr |
Date Detail:
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Created Date: 2012-05-18 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 2984771R Medline TA: Mil Med Country: United States |
Other Details:
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Languages: eng Pagination: 456-9 Citation Subset: IM |
Affiliation:
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Gastroenterology Department, Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Bethesda, MD 20889, USA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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