Predictors of mortality in patients with Clostridium difficile infection

Clostridium difficile infection (CDI) is one of the most common health-care-associated infections and has become a crucial cause of morbidity and mortality in older patients, but outcomes of CDI vary between patients. The aim of this study is to identify the predictor of mortality in patients with CDI. This is a retrospective study of patients with CDI diagnosed by stool C difficile toxin test between February 1, 2012 and August 31, 2017, in a medical center in Taiwan. The main outcome of the study was in-hospital mortality. A total of 101 patients were diagnosed with CDI during the study period. The in-hospital mortality rate was 28.7% (29 patients), and the recurrence rate was 6.9% (7 patients). By using multivariable logistic regression model, acute kidney injury was found to be a strong independent predictor of mortality (odds ratio [OR]: 6.64, 95% confidence interval [CI]: 2.07-21.25, P < .001). Having received chemotherapy in the preceding 3 months was also a significant predictor (OR: 22.54, 95% CI: 1.84-276.5, P = .015). Probiotic treatment was found to be a negative predictor of mortality (OR: 0.30, 95% CI: 0.10-0.95, P = .040). Acute kidney injury and recent chemotherapy could be predictors of in-hospital mortality in patients with CDI. Probiotic treatment may reduce the mortality of patients with CDI.