Document Detail


Clostridium difficile-associated diarrhea and colitis in adults. A prospective case-controlled epidemiologic study.
MedLine Citation:
PMID:  3942469     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In a one-year period, 149 adult cases of Clostridium difficile-associated diarrhea and colitis were compared with 148 diarrhea-free controls. Eighty-seven percent were nosocomial and 75% were on surgical services. Endoscopy revealed pseudomembranes in 51% of the 109 cases in which stool cytotoxin was present, compared with 11% of the 40 cases that were culture-positive but cytotoxin-negative. Cases diagnosed only by stool culture showed essentially no differences from controls, 21% of whom had asymptomatic stool colonization. We estimate that only 20% of these cases had diarrhea due to C difficile. Compared with controls, cases diagnosed by the presence of cytotoxin or pseudomembranes were found to have been hospitalized longer at diarrhea onset, to have had more antecedent infections, and to have received clindamycin, multiple antimicrobials, and therapeutic antimicrobials more often than controls, but controls received prophylactic antimicrobials more frequently than cases. Cultures of the environment, patients, and personnel failed to detect a mechanism of acquisition.
Authors:
D N Gerding; M M Olson; L R Peterson; D G Teasley; R L Gebhard; M L Schwartz; J T Lee
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Archives of internal medicine     Volume:  146     ISSN:  0003-9926     ISO Abbreviation:  Arch. Intern. Med.     Publication Date:  1986 Jan 
Date Detail:
Created Date:  1986-01-24     Completed Date:  1986-01-24     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0372440     Medline TA:  Arch Intern Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  95-100     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Anti-Bacterial Agents / adverse effects
Clostridium / isolation & purification
Clostridium Infections* / diagnosis
Cross Infection / diagnosis,  etiology*
Cytotoxins / analysis
Diarrhea / diagnosis,  etiology*
Endoscopy
Enterocolitis, Pseudomembranous / diagnosis,  etiology*
Feces / microbiology
Female
Humans
Male
Middle Aged
Prospective Studies
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Cytotoxins

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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