Skip Navigation LinksHome > August 2013 - Volume 41 - Issue 8 > Clostridium difficile Infection: A Multicenter Study of Epid...
Critical Care Medicine:
doi: 10.1097/CCM.0b013e31828a40d5
Clinical Investigations

Clostridium difficile Infection: A Multicenter Study of Epidemiology and Outcomes in Mechanically Ventilated Patients

Micek, Scott T. PharmD1,2; Schramm, Garrett PharmD3; Morrow, Lee MD4; Frazee, Erin PharmD3; Personett, Heather PharmD3; Doherty, Joshua A. BA5; Hampton, Nicholas PharmD5; Hoban, Alex BS6; Lieu, Angela7; McKenzie, Matthew2; Dubberke, Erik R. MD8; Kollef, Marin H. MD6

Collapse Box

Abstract

Objectives:

Clostridium difficile is a leading cause of hospital-associated infection in the United States. The purpose of this study is to assess the prevalence of C. difficile infection among mechanically ventilated patients within the ICUs of three academic hospitals and secondarily describe the influence of C. difficile infection on the outcomes of these patients.

Design:

A retrospective cohort study.

Setting:

ICUs at three teaching hospitals: Barnes-Jewish Hospital, Mayo Clinic, and Creighton University Medical Center over a 2-year period.

Patients:

All hospitalized patients requiring mechanical ventilation for greater than 48 hours within an ICU were eligible for inclusion.

Interventions:

None.

Measurements and Main Results:

A total of 5,852 consecutive patients admitted to the ICU were included. Three hundred eighty-six (6.6%) patients with development of C. difficile infection while in the hospital (5.39 cases/1,000 patient days). Septic shock complicating C. difficile infection occurred in 34.7% of patients. Compared with patients without C. difficile infection (n = 5,466), patients with C. difficile infection had a similar hospital mortality rate (25.1% vs 26.3%, p = 0.638). Patients with C. difficile infection were significantly more likely to be discharged to a skilled nursing or rehabilitation facility (42.4% vs 31.9%, p < 0.001), and the median hospital (23 d vs 15 d, p < 0.001) and ICU length of stay (12 d vs 8 d, p < 0.001) were found to be significantly longer in patients with C. difficile infection.

Conclusions:

Clostridium difficile infection is a relatively common nosocomial infection in mechanically ventilated patients and is associated with prolonged length of hospital and ICU stay, and increased need for skilled nursing care or rehabilitation following hospital discharge.

Copyright © 2013 by the Society of Critical Care Medicine and Lippincott Williams & Wilkins

Article Tools

Share

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.