22476273

PMC3657463

Background

The incidence of Clostridium difficile infection (CDI) has been increasing. Previous studies report that the number of colectomies for CDI is also rising. Outside of a few notable outbreaks, there are few published data documenting increasing severity of CDI. The specific aims of this multiyear, multicenter study were to assess CDI-related colectomy rates and compare CDI-related colectomy rates by CDI surveillance definition.

Methods

Cases of CDI and patients who underwent colectomy were identified electronically from 5 US tertiary-care centers from July 2000 through June 2006. Chart review was performed to determine if a colectomy was for CDI. Monthly CDI-related colectomy rates were calculated as the number of CDI-related colectomies per 1,000 CDI cases. Data between observational groups were compared using χ2 and Mann-Whitney U tests. Logistic regression was performed to evaluate risk factors for CDI-related colectomy.

Results

8569 cases of CDI were identified and 75 patients had CDI-related colectomy. The overall colectomy rate was 8.7/1,000 CDI cases. The CDI-related colectomy rate ranged from 0 to 23 per 1,000 CDI episodes across hospitals. The colectomy rates for healthcare facility (HCF)-onset CDI was 4.3/1000 CDI cases and 16.5 /1000 CDI cases for community-onset CDI (p <.05). There were significantly more CDI-related colectomies at hospitals B and C (p<.05).

Conclusions

The overall CDI-related colectomy rate was low, and there was no significant change in the CDI-related colectomy rate over time. Onset of disease outside of the study hospital was an independent risk factor for colectomy.

CDC Public Access

5U01C1000333/PHS HHS/United States
5U01CI000328/CI/NCPDCID CDC HHS/United States
5U01CI000334/CI/NCPDCID CDC HHS/United States
5U01CI000344/CI/NCPDCID CDC HHS/United States
K01AI065808/AI/NIAID NIH HHS/United States
K23 AI065806/AI/NIAID NIH HHS/United States
K23AI065806/AI/NIAID NIH HHS/United States
K24AI06779401/AI/NIAID NIH HHS/United States
L30 AI062141/AI/NIAID NIH HHS/United States
UR8/CCU715087-06/1/PHS HHS/United States