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

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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 cultureconfirmed 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, P50.003) and past CDI history within 3 months (OR 28.5, P50.003). In conclusion, the incidence and severity of CDI in our study were not higher than reported in Western countries.

Original languageEnglish
Article number070672
Pages (from-to)1542-1551
Number of pages10
JournalJournal of Medical Microbiology
Publication statusPublished - 2014 Nov 1


All Science Journal Classification (ASJC) codes

  • Microbiology
  • Microbiology (medical)

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