Low Vitamin D Level and Impact on Severity and Recurrence of Clostridium difficile Infections. Issue 1 (January 2015)

• Record Type: Journal Article
• Authors: Abdelfatah, Mohamed; Nayfe, Rabih; Moftakhar, Bahar; Nijim, Ala; El Zoghbi, Maysaa; Donskey, Curtis J.; Kandil, Hossam; Watkins, Richard R.
• Is Part Of: Journal of investigative medicine. Volume 63:Issue 1(2015:Jan.)
• Publication Date: 2015-01
• Subjects: Clinical medicine -- Periodicals; Medicine -- Research -- Periodicals; Medicine; Research -- United States; Clinical medicine; Medicine -- Research; Periodicals; 616.075
• DOI: 10.1097/JIM.0000000000000117
• Languages: English
• ISSNs: 1081-5589

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Background</title> <p> <italic>Clostridium difficile</italic> infection (CDI) has recently markedly increased, incurring greater health care–associated costs and hospitalizations especially in vitamin D deficient patients. Accordingly, the aim of this study was to evaluate the relationship between low vitamin D levels and the severity and recurrence of CDI.</p> </sec> <sec> <title>Methods</title> <p>A retrospective case-control study evaluated patients hospitalized between 2007 and 2013 with CDI and a positive <italic>C. difficile</italic> toxin assay. Severe complicated CDI was defined based on (1) laboratory or radiological criteria correlated clinically and (2) sepsis requiring intensive care unit admission. Recurrent CDI (RCDI) was defined as a new episode of diarrhea occurring within 90 days of resolution of the initial episode for at least 10 days after discontinuing therapy and confirmed by positive stool <italic>C. difficile</italic> toxin assay or polymerase chain reaction. Patients were divided into 4 groups based on vitamin D level (ng/mL): severely deficient (<10), insufficient (10-19.9), predeficient (20-29.9), and control group (≥30).</p> </sec> <sec> <title>Results</title> <p>Two hundred seventy-one patients were diagnosed with CDI, of which 48 had RCDI distributed as 5 (12.5%), 15 (16.1%), 10 (15.6%), and 13 (17.5%) patients in each of the aforementioned groups, respectively (<italic>P</italic>= 0.55). Severe complicated CDI was identified in 7 (17.5%), 17 (18.2%), 9 (14%), and 3 (4%) patients, respectively (<italic>P</italic> = 0.04). Thirty-day mortality was 1 of 40, 1 of 93, 2 of 64, and 2 of 74 patients, respectively (<italic>P</italic> = 0.43).</p> </sec> <sec> <title>Conclusions</title> <p>Normal vitamin D level has a protective effect against severe CDI, and low vitamin D is associated with greater severity of CDI but not with an increased risk of RCDI or 30-day mortality.</p> </sec> </abstract>