Journal article
Mild or malign: Clinical characteristics and outcomes of clostridium difficile infection in Thailand
Journal of Clinical Microbiology, Vol.58(9), pp.Art. e01217-e01220
2020
Abstract
Little is known about the clinical characteristics of Clostridium difficile infection (CDI) in Asia in general, and Thailand specifically, with a few studies suggesting that the disease may be milder than elsewhere. This study aimed to describe CDI in Thailand, evaluate treatment options and their outcomes, and explore possible protective factors responsible for any unique disease characteristics. From 2015 to 2018, 469 patients were included in the study. All patients had their stools tested for the tcdB gene by direct PCR and detection of toxigenic C. difficile by culture. C. difficile isolates were subjected to toxin gene profiling and ribotyping, and patient medical records were reviewed retrospectively. There were 248 and 221 patients included in CDI and control groups, respectively. The CDI group had a higher overall 30-day mortality rate than the control group (21% versus 14%, P = 0.046), but only 2 deaths (1%) were directly attributable to CDI. Metronidazole treatment was not inferior to vancomycin in this population, and vancomycin was associated with a higher 30-day mortality rate (P = 0.047). The prevalence of severe CDI and disease outcomes were not different between patients infected with A–B+ C. difficile and A+B+ C. difficile strains or between patients with and without colonization by nontoxigenic C. difficile. Besides C. difficile-specific tests, neither a single laboratory result nor a combination of results was predictive of CDI. In conclusion, CDI in Thailand was relatively mild, and metronidazole remained an effective treatment option for these mild infections.
Details
- Title
- Mild or malign: Clinical characteristics and outcomes of clostridium difficile infection in Thailand
- Authors/Creators
- K. Imwattana (Author/Creator) - The University of Western AustraliaP. Putsathit (Author/Creator) - Edith Cowan UniversityT. Leepattarakit (Author/Creator) - Siriraj HospitalP. Kiratisin (Author/Creator) - Siriraj HospitalT.V. Riley (Author/Creator) - The University of Western AustraliaA.B. Onderdonk (Author/Creator)
- Publication Details
- Journal of Clinical Microbiology, Vol.58(9), pp.Art. e01217-e01220
- Publisher
- American Society for Microbiology
- Identifiers
- 991005542448907891
- Copyright
- © 2020 American Society for Microbiology
- Murdoch Affiliation
- School of Veterinary and Life Sciences
- Language
- English
- Resource Type
- Journal article
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- Collaboration types
- Domestic collaboration
- International collaboration
- Citation topics
- 1 Clinical & Life Sciences
- 1.120 Inflammatory Bowel Diseases & Infections
- 1.120.1133 Clostridium Infections
- Web Of Science research areas
- Microbiology
- ESI research areas
- Microbiology