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Colitis More Common in Hospitalized Patients

e 78,091,119 discharges that occurred in the 11-year study period, 299,453 patients had a diagnosis of C. difficile colitis, a rate of 383 cases per 100,000 discharged patients.

The rate of C. difficile colitis discharges increased from 261 cases per 100,000 discharged patients in 1993 to 546 cases per 100,000 discharged patients in 2003, a 109 percent increase, the authors write. Colectomy rate, which was 2.7 per 1,000 patients overall, increased from 1.2 per 1,000 patients in 1993 to 3.4 per 1,000 patients in 2003.

The total rate of death among patients with C. difficile colitis was 33.6 deaths per 100,000 discharged patients throughout the study; this rate increased 147 percent in 11 years, from 20.3 deaths per 100,000 discharged patients in 1993 to 50.2 deaths per 100,000 discharged patients in 2003.

Hospital discharge with a C. difficile diagnosis was significantly more likely with increasing calendar year, the authors continue. In addition, the likelihood of death and of treatment with colectomy also significantly increased over time.

The results document the changing nature of C. difficile colitis but do not offer explanations for the change, the authors note. The shift could be caused by new strains of the bacteria, its increasing resistance to antibiotics or the increasing severity of illness and therefore susceptibility to infection among hospitalized patients in the United States. Heightened awareness of the increasing disease burden of C. difficile colitis is an important first step in controlling the public health ramifications of this important and morbid nosocomial [hospital-acquired] infection, they conclude. (Arch Surg. 2007;142(7):624-631. Available pre-embargo to the media at www.jamamedia.org.) Editors Note: This study was supported by the University of Minnesota Academic Health Centers Clinical Scholars Research Grant. Please see the article for additional information, including other authors, author
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