The Korean Journal of Gastroenterology (대한소화기학회지)

The Korean Society of Gastroenterology (대한소화기학회)
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The Incidence and Clinical Features of Clostridium difficile Infection; Single Center Study

Clostridium difficile 감염의 발생률 및 임상 양상; 단일기관 연구

Lee, Jin-Ho;Lee, Su-Yeon;Kim, You-Sun;Park, Sun-Wook;Park, Sung-Won;Jo, So-Young;Ryu, Soo-Hyung;Lee, Jung-Hwan;Moon, Jeong-Seop;Whang, Dong-Hee;Shin, Bo-Moon
이진호;이수연;김유선;박선욱;박성원;조소영;류수형;이정환;문정섭;황동희;신보문

  • Published : 20100000
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Abstract

Background/Aims: Clostridium difficile is the predominant cause of nosocomial diarrhea. Recently, the incidence of Clostridium difficile infection (CDI) increases in Europe and North America. A retrospective study was performed to evaluate the change of incidence and clinical features of CDI in Korea. Methods: From January 2003 to December 2008, inpatients diagnosed with CDI in Seoul Paik hospital were enrolled. The diagnosis of CDI was made when patients complained diarrhea with any positive results in C. difficile toxin assay, stool culture, or endoscopy. The incidence, recurrence rate, and clinical features were compared between early period (2003-2005) and late period (2006-2008). Results: The incidence of CDI was 21.73 cases per 10,000 admitted patients in early period group, and significantly increased to 71.71 cases per 10,000 admitted patients in late period group (p＜0.01). The hospital stay duration at the time of CDI diagnosis was shorter in late period group. Cephalosporin had the highest ratio as the causative antibiotics of CDI. However, there was no difference in recurrence rate between early and late period groups. Recurrence associated clinical factor was serum albumin level. Conclusions: The incidence of CDI showed increasing tendency during recent 6 years. The awareness of increasing disease burden is the first step in control of CDI.

목적: Clostridium difficile 감염(C. difficile infection, CDI)은 병원성 설사의 가장 흔한 원인이며, 항생제를 많이 사용하거나 주위 환경이 C. difficile 포자로 감염된 경우 발생빈도는 증가한다. 최근 유럽과 북미에서 CDI의 발생률이 증가하고 있어 저자들은 국내에서 CDI의 발생률의 변화에 대해 파악하고자 했다. 대상 및 방법: 2003년 1월부터 2008년 12월까지 6년간 서울백병원에서 입원한 환자 중 CDI로 진단된 18세 이상 환자들을 대상으로 후향 분석하였다. CDI의 진단은 설사와 함께 대변검사에서 C. difficile toxin이 양성이거나 C. difficile이 동정된 경우 또는 위막 대장염이 진단된 경우로 정하였다. 2003-2005년을 초반기군으로, 2006- 2008년을 후반기군으로 나누어 발생률, 재발률 및 임상 경과를 비교했다. 결과: CDI의 발생률은 전반기군에서 입원 환자 만 명당 21.73명이었으며 후반기군은 입원환자 만 명당 71.71명으로 초반기군보다 의미 있게 증가하였다(p＜ 0.01). CDI 발생 시 재원기간은 후반기군에서 전반기군에 비해 짧았고(p ＜0.01) 원인 항생제로는 cephalosporin이 가장 높은 비율을 차지하였다. 재발률은 두 군 사이에 차이가 없었으며(p= 0.973), 재발과 연관된 인자는 혈청 알부민 수치였다. 결론: 이번 연구는 6년 동안 CDI의 증가된 발생률을 관찰한 단일 기관 연구이다. CDI 발생률이 증가하고 있다는 인식이 이질환의 관리에 중요한 초석이다.

Keywords

References

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