Older age , use of antibiotics after diagnosis , use of proton pump inhibitors , and strain type were the most frequent risk factors for recurrence .
Older age , leucocytosis , renal failure and co-morbidities were frequent risk factors for complicated CDI .
When considered alone , mortality was associated with age , co-morbidities , hypo-albuminemia , leucocytosis , acute renal failure , and infection with ribotype 027 .
BACKGROUND Clostridium difficile infection ( CDI ) can lead to complications , recurrence , and death .
Numerous studies have assessed risk factors for these unfavourable outcomes , but systematic review s or meta-analyses published so far were limited in scope or in quality .
Vitamin D status and severity of Clostridium difficile infections: a prospective cohort study in hospitalized adults.
BACKGROUND Clostridium difficile is the most common cause of nosocomial diarrhea , affecting up to 10 % of hospitalized patients . Preliminary studies suggest an association between vitamin D status and C difficile infections ( CDIs ) . Our goal was to investigate whether serum 25-hydroxyvitamin D ( 25(OH)D ) levels are associated with CDI severity . METHODS We prospect ively enrolled patients diagnosed with CDI and divided them into 2 severity groups : group A ( positive toxin A/B enzyme immunoassay only ) and group B ( positive toxin A/B enzyme immunoassay with abdominal computed tomography scan findings consistent with colitis ) .  Serum 25(OH)D levels ( 25(OH)D3 , 25(OH)D2 , and total 25(OH)D ) were measured on all patients after diagnosis of CDI . We performed multivariable logistic regression analyses to investigate the association between 25(OH)D levels and CDI severity , while adjusting for age , Deyo-Charlson Comorbidity Index , recent hospitalization , and vitamin D supplementation . RESULTS One hundred patients were enrolled between July 2011 and February 2013 . The mean ( st and ard deviation ) cohort age and Deyo-Charlson Comorbidity Index were 62 ( 19 ) years and 4 ( 3 ) , respectively ; 54 % of patients were male . Mean serum total 25(OH)D level was 22 ( 10 ) ng/mL. Mean 25(OH)D3 level was significantly higher in group A ( n = 71 ) than in group B ( n = 29 ) : 21 ( 1 ) vs 15 ( 2 ) ng/mL , respectively ( P = .005 ) . There was no observed difference in mean 25(OH)D2 levels and total 25(OH)D levels between the 2 groups . Multivariable logistic regression analysis demonstrated an association between 25(OH)D3 levels and CDI severity ( adjusted odds ratio , 0.92 ; 95 % confidence interval , 0.87 - 0.98 ) . CONCLUSIONS We found a significant inverse association between 25(OH)D3 levels and CDI severity . Further studies are needed to determine whether vitamin D supplementation can improve outcomes in patients with CDI
Older age , use of antibiotics after diagnosis , use of proton pump inhibitors , and strain type were the most frequent risk factors for recurrence .
Older age , leucocytosis , renal failure and co-morbidities were frequent risk factors for complicated CDI .
When considered alone , mortality was associated with age , co-morbidities , hypo-albuminemia , leucocytosis , acute renal failure , and infection with ribotype 027 .
BACKGROUND Clostridium difficile infection ( CDI ) can lead to complications , recurrence , and death .
Numerous studies have assessed risk factors for these unfavourable outcomes , but systematic review s or meta-analyses published so far were limited in scope or in quality .