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Mortality and Clostridium difficile infection in an Australian setting

Citation

Mitchell, BG and Gardner, A and Hiller, J, Mortality and Clostridium difficile infection in an Australian setting, Journal of Advanced Nursing, 69, (10) pp. 2162-2171. ISSN 1365-2648 (2013) [Refereed Article]

Copyright Statement

Copyright 2013 Blackwell Publishing Ltd

DOI: doi:10.1111/jan.12078

Abstract

Aim: To quantify the risk of death associated with Clostridium difficile infection, in an Australian tertiary hospital.

Background: Two reviews examining Clostridium difficile infection and mortality indicate that Clostridium difficile infection is associated with increased mortality in hospitalized patients. Studies investigating the mortality of Clostridium difficile infection in settings outside of Europe and North America are required, so that the epidemiology of Clostridium difficile infection in these regions can be understood and appropriate prevention strategies made.

Design: An observational non-concurrent cohort study design was used.

Methods: Data from all persons who had (exposed) and a matched sample of persons who did not have Clostridium difficile infection, for the calendar years 2007–2010, were analysed. The risk of dying within 30, 60, 90 and 180 days was compared using the two groups. Kaplan–Meier survival analysis and conditional logistic regression models were applied to the data to examine time to death and mortality risk adjusted for comorbidities using the Charlson Comorbidity Index.

Results: One hundred and fifty-eight cases of infection were identified. A statistically significant difference in all-cause mortality was identified between exposed and non-exposed groups at 60 and 180 days. In a conditional regression model, mortality in the exposed group was significantly higher at 180 days.

Conclusion: In this Australian study, Clostridium difficile infection was associated with increased mortality. In doing so, it highlights the need for nurses to immediately instigate contact precautions for persons suspected of having Clostridium difficile infection and to facilitate a timely faecal collection for testing. Our findings support ongoing surveillance of Clostridium difficile infection and associated prevention and control activities.

Item Details

Item Type:Refereed Article
Keywords:Australia, Clostridium difficile-associated diarrhoea, Clostridium difficile infection, death, healthcare-associated infection, infection control, mortality, nurse, nursing
Research Division:Medical and Health Sciences
Research Group:Nursing
Research Field:Nursing not elsewhere classified
Objective Division:Health
Objective Group:Public Health (excl. Specific Population Health)
Objective Field:Disease Distribution and Transmission (incl. Surveillance and Response)
Author:Mitchell, BG (Mr Brett Mitchell)
ID Code:83132
Year Published:2013
Web of Science® Times Cited:4
Deposited By:Health Sciences B
Deposited On:2013-03-01
Last Modified:2015-06-25
Downloads:3 View Download Statistics

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