Table 2. Clinical characteristics and treatment outcomes of Clostridium difficile infections with ribotypes 017 (R017) and 018 (R018).
| total number = 510 | ribotype 017 vs. others | ribotype 018 vs. others | ribotype 018 vs. ribotype 017 | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Characteristics | ribotype 017 (N = 139) | ribotype 018 (N = 157) | others (N = 214) | simple OR | p value | multiple OR | p value | simple OR | p value | multiple OR | p value | simple OR | p value | multiple OR | p value |
| CDI episode | |||||||||||||||
| 1st CDI | 117 (84.2) | 127 (80.9) | 185 (86.4) | ||||||||||||
| Recurred CDI | 22 (15.8) | 30 (19.1) | 29 (13.6) | 1.2 (0.66, 2.19) | 0.553 | 1.51 (0.86, 2.63) | 0.15 | 1.26 (0.69, 2.3) | 0.46 | ||||||
| Laboratory findings median (1Q, 3Q) | |||||||||||||||
| WBC (*103/mm3) | 8000 (6300,13000) | 9800 (7200,15400) | 8650 (900,12325) | 1.00 (1.00, 1.00) | 0.21 | 1.00 (1.00, 1.00) | 0.007 | 1.00 (1.00, 1.00) | 0.258 | ||||||
| Albumin (mg/dL) | 3.0 (2.6,3.4) | 3.0 (2.7,3.5) | 3.2 (2.8,3.5) | 0.57 (0.38, 0.84) | 0.004 | 0.47 (0.31, 0.73) | 0.001 | 0.78 (0.53, 1.15) | 0.207 | 1.41 (0.94, 2.13) | 0.097 | ||||
| CRP | 3.25 (0.88,8.03) | 5.6 (2.0,12.2) | 4.5 (1.7,9.15) | 0.97 (0.94, 1.01) | 0.116 | 0.96 (0.92, 0.99) | 0.022 | 1.02 (0.99, 1.05) | 0.155 | 1.05 (1.01, 1.08) | 0.009 | 1.04 (1.01, 1.08) | 0.021 | ||
| Disease severity n (%) | |||||||||||||||
| Old agea | 102 (73.4) | 125 (79.6) | 140 (65.4) | 1.46 (0.91, 2.33) | 0.116 | 2.07 (1.28, 3.34) | 0.003 | 1.42 (0.83, 2.43) | 0.206 | ||||||
| Feverb | 11 (7.9) | 22 (14.0) | 20 (9.3) | 0.83 (0.39, 1.80) | 0.643 | 1.58 (0.83, 3.01) | 0.164 | 1.90 (0.88, 4.07) | 0.1 | ||||||
| Leukocytosisc | 23 (16.7) | 40 (25.5) | 31 (14.5) | 1.17 (0.65, 2.11) | 0.599 | 2.02 (1.20, 3.41) | 0.009 | 1.72 (0.97, 3.06) | 0.063 | ||||||
| Hypoalbuminemiad | 25 (18.0) | 16 (10.2) | 18 (8.4) | 2.39 (1.25, 4.57) | 0.009 | 1.24 (0.61, 2.51) | 0.558 | 0.52 (0.26, 1.02) | 0.055 | 0.41 (0.20, 0.84) | 0.014 | ||||
| Azotemiae | 6 (4.3) | 12 (7.6) | 5 (2.3) | 1.89 (0.56, 6.30) | 0.303 | 3.46 (1.19, 10.03) | 0.022 | 4.06 (1.28, 12.91) | 0.018 | 1.83 (0.67, 5.03) | 0.238 | ||||
| Severity index n (%) | |||||||||||||||
| Severe CDIf | 26 (18.7) | 48 (30.6) | 34 (15.9) | 1.22 (0.69, 2.14) | 0.492 | 2.33 (1.42, 3.84) | 0.001 | 1.68 (1.03, 2.72) | 0.036 | 1.88 (1.05, 3.37) | 0.034 | ||||
| Severe CDIg | 37 (26.6) | 55 (35.0) | 40 (18.7) | 1.58 (0.95, 2.63) | 0.079 | 2.35 (1.46, 3.77) | <0.001 | 1.87 (1.12, 3.13) | 0.016 | 1.25 (0.93, 1.68) | 0.14 | ||||
| EIA toxin assay-positive | 90/139 (64.7) | 120/156 (76.9) | 91/213 (42.7) | 2.46 (1.58, 3.83) | <0.001 | 2.59 (1.65, 4.09) | <0.001 | 4.47 (2.82, 7.09) | <0.001 | 4.55 (2.82, 7.33) | <0.001 | 1.22 (0.64, 2.34) | 0.541 | ||
| PMC in image study n (%) | 13/26 (50.0) | 18/41 (43.9) | 17/58 (29.3) | 2.41 (0.93, 6.26) | 0.071 | 1.89 (0.82, 4.36) | 0.137 | 0.78 (0.29, 2.10) | 0.783 | ||||||
| Received treatment n (%) | 95 (68.3) | 117 (74.5) | 114 (53.3) | 1.89 (1.21, 2.96) | 0.005 | 2.57 (1.64, 4.02) | <0.001 | 1.36 (0.82, 2.25) | 0.24 | ||||||
| Vancomycin | 7 (7.4) | 11 (9.4) | 10 (8.8) | 0.83 (0.30, 2.26) | 0.712 | 1.08 (0.44, 2.65) | 0.868 | 1.31 (0.49, 3.51) | 0.598 | ||||||
| Metronidazole | 88 (92.6) | 106 (90.6) | 104 (91.2) | ||||||||||||
| Clinical outcome n (%) | 95 | 117 | 114 | ||||||||||||
| Clinical success | 72 (75.8) | 100 (85.5) | 95 (83.3) | 0.63 (0.32, 1.24) | 0.177 | 1.18 (0.58, 2.40) | 0.655 | 1.24 (0.71, 2.17) | 0.445 | ||||||
| Recurrenceh | 13 (13.7) | 20 (17.1) | 12 (10.5) | 1.54 (0.66, 3.60) | 0.324 | 1.79 (0.82, 3.91) | 0.141 | 1.17 (0.54, 2.54) | 0.694 | ||||||
| 30-day mortality | 13 (9.4) | 7 (4.5) | 7 (3.3) | 3.24 (0.98, 10.67) | 0.054 | 1.23 (0.32, 4.69) | 0.764 | 0.38 (0.13, 1.15) | 0.087 | ||||||
| Attributable mortality | 3 (2.2) | 2 (1.3) | 1 (0.5) | 3.69 (0.38, 36.02) | 0.262 | 1.97 (0.18, 21.98) | 0.583 | 0.53 (0.09, 3.26) | 0.496 | ||||||
CDI, Clostridium difficile infection; WBC, white blood cell; CRP, C-reactive protein; PMC, pseudomembranous colitis; EIA, enzyme immunoassay
aAge > 60
bTemperature >38.3°C
cPeripheral WBC > 15,000/mm3
dSerum albumin <2.5 mg/dL
eSerum creatinine level ≥ 1.5 times the premorbid level
fLeukocytosis or azotemia
gTwo or more of 4 factors: age > 60 years, temperature > 38.3°C, albumin level < 2.5 mg/dL, or WBC count ≥ 15,000 cells/μL
hRecurrence within 30 days after treatment