TABLE 1.
Clinical outcome in CDAD patients in relation to bacteriological data
| Fate of C. difficilea | Outcomec
|
|||||||
|---|---|---|---|---|---|---|---|---|
| Permanent cure
|
Failure
|
Recurrence
|
All patients
|
|||||
| nd | %e | nd | % | nd | % | nd | % | |
| Persistence at follow-up | ||||||||
| Fusidic acid therapy | ||||||||
| Susceptible follow-up isolate | 5 (4/1) | 56e | 1 (1/0) | 11 | 3 (1/2) | 33 | 9 (6/3) | 100 |
| Resistant follow-up isolateb | 5 (4/1) | 46f | 3 (3/0) | 27 | 3 (2/1) | 27 | 11 (9/2) | 100 |
| Metronidazole therapy | 12 (8/4) | 57g | 1 (1/0) | 5 | 8 (7/1) | 38 | 21 (16/5) | 100 |
| Both treatment groups | 22 (16/6) | 54h | 5 (5/0) | 12 | 14 (10/4) | 34 | 41 (31/10) | 100 |
| Permanent eradication | ||||||||
| Fusidic acid therapy | 19 | 79i | 2 | 8 | 3 | 13 | 24 | 100 |
| Metronidazole therapy | 17 | 74k | 1 | 4 | 5 | 22 | 23 | 100 |
| Both treatment groups | 36 | 77l | 3 | 6 | 8 | 17 | 47 | 100 |
Persistence refers to culture positivity on days 8 to 13 and/or days 35 to 40. Culture negativity for C. difficile on both these occasions was defined as permanent eradication.
One cured patient carried a resistant mutant of the initial PCR ribotype on days 8 to 13 but later acquired reinfection due to a susceptible strain of a different ribotype (patient 7 in TABLE 2).
Permanent cure was defined as no diarrhea on days 8 to 13 or later, failure was persistence of diarrhea on days 8 to 13, and recurrence as cure on days 8 to 13 followed by diarrhea before day 40.
The numbers in parentheses refer to patients with identical/new PCR ribotype of C. difficile compared to that of the pretherapy isolate.
The P values were the following: e versus f, P = 1.0; e plus f versus g, P = 0.76; i versus k, P = 0.74; e plus f plus i versus g plus k, P = 1.0; h versus l, P = 0.03.