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Clinical characteristics of relapses and re-infections in Clostridium difficile infection

Title
Clinical characteristics of relapses and re-infections in Clostridium difficile infection
Author
김지은
Keywords
Clostridium difficile infection; multilocus variable-number tandem-repeat analysis; PCR ribotyping; recurrence; re-infection; relapse
Issue Date
2014-11
Publisher
Wiley-Blackwell
Citation
CLINICAL MICROBIOLOGY AND INFECTION, 2012, 20(11), P.1198-1204
Abstract
The purpose of this study was to identify factors associated with relapses or re-infections in patients with recurring Clostridium difficile infections (CDIs). From September 2008 to January 2012, cases with two or more isolates from consecutive CDI episodes were included. PCR-ribotyping and multilocus variable-number tandem-repeat analysis were performed using paired isolates. Among 473 patients, 68 (14.4%) experienced one to five recurrences. Fifty-one of these with two or more isolates from consecutive CDI episodes were included in the study; 25 (49%) were classified as relapses and 26 (51%) as re-infections. Recurrence interval was shorter in the relapse group (26.0 versus 67.5 p0.001), but more patients in the re-infection group were hospitalized during recurrence interval (53.8% versus 8.0%, p<0.001). Relapse rates in infections by ribotype 017, ribotype 018 and other ribotypes were 63.6%, 63.6% and 22.2%, respectively (p0.274, p0.069, and p0.005). In multivariate logistic regression, infections by ribotypes 017 and 018 were associated with CDI relapse (OR 4.77, 95% CI 1.02-22.31, p0.047; OR 11.49, 95% CI 2.07-63.72, p0.005). Conversely, admission during recurrence interval lowered the risk of relapse (OR 0.044, 95% CI 0.006-0.344, p0.003). In conclusion, relapse was more likely when infection was caused by PCR ribotypes 017 and 018.
URI
http://www.clinicalmicrobiologyandinfection.com/article/S1198-743X(14)65318-0/fulltexthttp://hdl.handle.net/20.500.11754/53286
ISSN
1198-743X; 1469-0691
DOI
10.1111/1469-0691.12704
Appears in Collections:
COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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