Division of Gastroenterology, Mayo Clinic, Rochester, MN, USA.
Aliment Pharmacol Ther. 2012 Mar;35(5):613-8. doi: 10.1111/j.1365-2036.2011.04984.x. Epub 2012 Jan 10.
Community-acquired Clostridium difficile infection (CA-CDI) is an increasingly appreciated condition. It is being described in populations lacking traditional predisposing factors that have been previously considered at low-risk for this infection. As most studies of CDI are hospital-based, outcomes in these patients are not well known.
To examine outcomes and their predictors in patients with CA-CDI.
A sub-group analysis of a population-based epidemiological study of CDI in Olmsted county, Minnesota from 1991-2005 was performed. Data regarding outcomes, including severity, treatment response, need for hospitalisation and recurrence were analysed.
Of 157 CA-CDI cases, the median age was 50 years and 75.3% were female. Among all CA-CDI cases, 40% required hospitalisation, 20% had severe and 4.4% had severe-complicated infection, 20% had treatment failure and 28% had recurrent CDI. Patients who required hospitalisation were significantly older (64 years vs. 44 years, P < 0.001), more likely to have severe disease (33.3% vs. 11.7%, P = 0.001), and had higher mean Charlson comorbidity index scores (2.06 vs. 0.84, P = 0.001). They had similar treatment failure and recurrence rates as patients who did not require hospitalisation.
Community-acquired Clostridium difficile infection can be associated with complications and poor outcomes, including hospitalisation and severe Clostridium difficile infection. As the incidence of community-acquired Clostridium difficile infection increases, clinicians should be aware of risk factors (increasing age, comorbid conditions and disease severity) that predict the need for hospitalisation and complications in patients with community-acquired Clostridium difficile infection.
社区获得性艰难梭菌感染（CA-CDI）是一种日益受到关注的疾病。它正在被描述为缺乏先前被认为感染风险较低的传统易感因素的人群中发生。由于大多数 CDI 研究都是基于医院的，因此这些患者的结局尚不清楚。
研究 CA-CDI 患者的结局及其预测因素。
对明尼苏达州奥姆斯特德县 1991-2005 年一项基于人群的 CDI 流行病学研究进行亚组分析。分析了结局相关数据，包括严重程度、治疗反应、住院需求和复发情况。
在 157 例 CA-CDI 病例中，中位年龄为 50 岁，75.3%为女性。在所有 CA-CDI 病例中，40%需要住院，20%患有严重疾病，4.4%患有严重合并感染，20%治疗失败，28%复发 CDI。需要住院的患者年龄明显较大（64 岁 vs. 44 岁，P < 0.001），更有可能患有严重疾病（33.3% vs. 11.7%，P = 0.001），且 Charlson 合并症指数评分更高（2.06 vs. 0.84，P = 0.001）。他们的治疗失败和复发率与不需要住院的患者相似。
社区获得性艰难梭菌感染可导致并发症和不良结局，包括住院和严重艰难梭菌感染。随着社区获得性艰难梭菌感染的发病率增加，临床医生应了解预测患者需要住院和并发症的危险因素（年龄增加、合并症和疾病严重程度）。
