Clostridioides difficile ; Risk factor ; Severe infection
Abstract
Background: There has been a marked increase in the mortality rate associated with
Clostridioides difficile infection (CDI) globally since 2003, with the emergence of binary toxin producing ribotype 027 strains. However, the molecular epidemiology of C. difficile shows
regional differences and ribotype 027 is not common in Korea. In this study, the risk factors
for severe CDI were evaluated, while considering the region-specific molecular epidemiology.
Methods: A retrospective case-control study was performed. Cases (n = 149) included patients
with severe CDI or severe complicated CDI. Controls (n = 155) consisted of patients with non severe CDI.
Results: Advanced age (odds ratio [OR] = 1.017, P = 0.0358), a history of chemotherapy (OR =
2.695, P = 0.0464), and ribotype 002 (OR = 3.406, P = 0.0231) were statistically significant factors
associated with severe CDI in a multivariate analysis.
Conclusion: Ribotype 002 was found to be a significant risk factor for severe CDI in this study.
Therefore, the surveillance of C. difficile ribotypes is recommended to monitor the spread of
high-risk clones