Epidemiology of Nosocomial Clostridium difficile Disease in Taiwan

Shan-Chwen Chang

2009 Vol.25 NO.3

Correspondence Author: Shan-Chwen Chang


Recent studies have shown that the epidemic strain of Clostridium
difficile known as NAP1, B1, or 027 continues to cause concern in North
America and Europe. Since this strain produces more toxins that increase
severity of infected cases and a higher failure rate of metronidazole
treatment than patients infected with other strains, the increase in
incidence has attracted attention internationally. However, prior studies of
C. difficile in Taiwan were mainly limited to individual hospitals or wards,
and analyses of incidence and antibiotics resistance are not available in the
past five years. In this study, we analyzed epidemiology of C. difficilebased on the Taiwan Nosocomial Infection Surveillance (TNIS) system built by the Centers for Disease Control (CDC) in 2007. 225 reported nosocomial C. difficile diseases. The male to female ratio was 1.6 to 1, and the mean age was 66. The highest antibiotics resistance rate was clindamycin (48%), followed by ampicillin (42%). We found that number of cases with nosocomial C. difficile disease had increased significantly in recent years. Cases have increased 5.6 folds during the study period (2003-2007). Among those cases, 73% were over 65 years old, showing that the elderly people are the target risk population. The infection risk has increased recently, which has also been shown by other studies. We hope results based on analyzing C. difficile disease from TNIS will provide information for prevention of nosocomial infections in the future.