Authors: L M Søes H M Holt B Böttiger H V Nielsen M Torpdahl E M Nielsen S Ethelberg K Mølbak V Andreasen M Kemp K E P Olsen
Publish Date: 2013/12/19
Volume: 33, Issue: 6, Pages: 957-967
Abstract
Clostridium difficile infection CDI is gradually being recognised as a cause of morbidity in the community We investigated the incidence and clinical characteristics of CDI in a community setting and characterised the C difficile strains by toxin gene profiling and polymerase chain reaction PCR ribotyping Patients included in the study had attended general practice primarily because of diarrhoea CDI patients 259 patients 121 2 years of age had positive cultures for toxigenic C difficile and nonCDI patients 455 patients were culturenegative Outcome variables included the frequency and duration of diarrhoea vomiting stomach ache fever 38 °C weight loss and sick leave Data were analysed by logistic regression CDI patients 2 and ≥2 years of age with C difficile as the only enteropathogen in the faecal sample reported slimy stools 65 vs 62 stomach ache 60 vs 75 weight loss 50 vs 76 and duration of diarrhoea 15 days 59 vs 73 as the predominant symptoms CDI patients ≥2 years old reported duration of diarrhoea 15 days more often compared to nonCDI patients 73 vs 27 p 00001 The annual incidence of CDI was 518 and 23/100000 for patients 2 and ≥2 years of age respectively and 46/100000 in the subgroup of patients ≥60 years of age CDI was characterised by stomach ache and persistent diarrhoea often leading to weight loss This emphasises the importance of diagnosing CDI not only in hospitalised patients but also in individuals ≥2 years of age attending general practice because of gastrointestinal symptoms especially in the elderly where the incidence of CDI is high
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