Recurrent Clostridioides difficile infection in surgery and outpatient units: A 12-year study

• Published in: Journal of Japan Society for Surgical Infection Vol. 16; no. 3; pp. 173 - 179
• Main Authors: Yoshida, Junichi, Kikuchi, Tetsuya, Ueno, Takako, Mataga, Akiko, Asano, Ikuyo, Tamura, Tetsuro
• Format: Journal Article
• Language: Japanese
• Published: Japan Society for Surgical Infection 30.06.2019
• ISSN: 1349-5755; 2434-0103
• DOI: 10.24679/gekakansen.16.3_173

【Objective】 Paucity of Japanese literature on recurrent Clostridioides difficile infection (CDI) prompted investigation on risk in outpatients and inpatients using antimicrobial use density (AUD). 【Methods】 Recurrence was defined as diarrhea and positive toxin test (CDT) on 29 days or after CDI. Subjects were outpatients and inpatients in 10 wards 2007 through 2018. We analyzed statistics for CDT and CDI recurrence. We defined recurrence density, for which regression analysis was made for AUD. The internal review board approved ethics. 【Results】 In a total of 2,358 CDTs, 301 CDI patients, 22 recurrent patients (7.3％), outpatient units had 3 patients (0.9％) and the surgical ward had 6 patients (0.9％) without significant difference. For recurrence density in inpatients, AUDs of ampicillin/sulbactam, ceftazidime, meropenem, and piperacillin/tazobactam were significant (P＜0.05). 【Conclusion】 Outpatients with diarrhea need differential diagnosis of CDI. Surgical wards run risk of CDI as do broadspectrum antimicrobials, thus indicating intervention.