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Volume 47, Number 6, December 2015

Clinical manifestations of Clostridium difficile infection in a medical center in Taiwan 

Chih-Cheng Lai, Sheng-Hsiang Lin, Che-Kim Tan, Chun-Hsing Liao, Yu-Tsung Huang, Po-Ren Hsueh

Received: November 6, 2012    Revised: June 10, 2013    Accepted: June 24, 2013   


Corresponding author:

Corresponding author. Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of
Medicine, Taipei, Taiwan.
E-mail address: (P.-R. Hsueh) 


Background and purpose: 

To investigate the clinical characteristics of Clostridium difficile infection (CDI) at a medical center in Taiwan.



Patients with CDI were identified from medical records at the National Taiwan University Hospital (Taipei, Taiwan). The following information was gathered and analyzed to better understand the clinical manifestations of CDI: age; sex; underlying immunocompromised conditions; laboratory data; in-hospital mortality; and previous use of drugs such as antimicrobial agents, steroids, and antipeptic ulcer agents. 



During the years 2000–2010, 122 patients were identified as having CDI. This included 92 patients with nontoxigenic CDI (i.e., positive stool culture for C. difficile but negative results for toxins A and B) and 30 patients with toxigenic CDI (i.e., positive stool culture cultures for C. difficile and positive results for toxins A and B). Of the 122 patients, 48 (39%) patients were older than 65 years and most patients acquired the CDI while in the hospital. Active cancer was the most common reason for hospitalization, followed by diabetes mellitus, and end-stage renal disease. More than 90% of the patients had received antibiotics before acquiring CDI. The results of fecal leukocyte examinations were positive in 33 (27%) patients. The overall in-hospital mortality rate was 26.2%. There were no significant differences between patients with nontoxigenic CDI and patients with toxigenic CDI. 



Clostridium difficile infection can develop in healthcare facilities and in community settings, especially in immunocompromised patients. 


Key words:

Clostridium difficile, Epidemiology, Infection, Taiwan