Læknablaðið - 15.09.2010, Blaðsíða 17

Clostridium difficile infections at Landspítali - 1998-2008
FRÆÐIGREINAR
RANNSÓKN
Objective: To study the epidemiology and severity of C.
difficile infections (CDI) at Landspítali over 11 year period,
1998-2008.
Material and methods: CDI were identified by a positive
toxin assay in stools from the database of the Department
of Microbiology. Chart review was conducted on patients
diagnosed in January and June each year during the study
period, a total of 237 infections.
Results: Overall, 1,861 of 11,968 submitted stool samples
were positive for C. difficile toxin, representing 1,492
infections. The population-based incidence was 29%
higher in the end than in the beginning of the period and
was highest in the age group >80 years where it was
387 cases per 100,000 person-years. The incidence per
1,000 admissions and 10,000 hospital days increased
by 71% and 102%, respectively. 47% of the infections
were nosocomial. Most patients had history of antibiotic
exposure prior to the infection and the most common
symptom was diarrhea. Response to a single antibiotics
course was good (93%). No patient required surgery due
to colitis.
Conclusion: The incidence of CDI was higher in 2008
than 11 years before. Most patients had well characterized
risk factors for CDI. For most patients a single course of
metronidazole treatment resolved the infection. Based
on these data, the severity of CDI does not seem to be
increasing in lceland.
Kvaran RB, ValsdottirEB, Sigurdsson HK, Gottfredsson M.
Clostridium difficile infections in Landspítali 1998-2008 lcel Med J 2010; 96:523-9
Key words: Clostridium difficile, antibiotics, colitis, epidemiology, nosocomial infections.
Correspondence: Elsa Björk Valsdóttir elsava@landspitali.is
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Barst: 29. mars 2010, - samþykkt til birtingar: 9. ágúst 2010
Hagsmunatengsl: Engin
LÆKNAblaðið 2010/96 529