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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 
 JOURNAL OF MEDICAL MICROBIOLOGY, Vol.63(11) : 1542-1551, 2014 
Journal Title
Issue Date
Bacterial Toxins/metabolism ; Bacteriological Techniques ; Clostridium difficile/isolation & purification* ; Cross Infection/microbiology* ; Enterocolitis, Pseudomembranous/epidemiology ; Enterocolitis, Pseudomembranous/microbiology* ; Humans ; Incidence ; Odds Ratio ; Republic of Korea/epidemiology ; Tertiary Care Centers*
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 culture-confirmed 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, P=0.003) and past CDI history within 3 months (OR 28.5, P=0.003). In conclusion, the incidence and severity of CDI in our study were not higher than reported in Western countries.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers
Yonsei Authors
Kim, June Myung(김준명)
Kim, Heejung(김희정) ORCID logo https://orcid.org/0000-0002-0190-703X
Lee, Kyungwon(이경원) ORCID logo https://orcid.org/0000-0003-3788-2134
Jeong, Su Jin(정수진) ORCID logo https://orcid.org/0000-0003-4025-4542
Choi, Jun Yong(최준용) ORCID logo https://orcid.org/0000-0002-2775-3315
Han, Sang Hoon(한상훈) ORCID logo https://orcid.org/0000-0002-4278-5198
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