Prolonged Clostridium difficile Infection May Be Associated With Vitamin D Deficiency

Abstract

Background: Clostridium difficile infection (CDI) is one of the leading causes of hospital-acquired infections, creating a financial burden for the U.S. healthcare system. Reports suggest that vitamin D–deficient CDI patients incur higher healthcare-associated expenses and longer lengths of stay compared to nondeficient counterparts. The objective here was to evaluate the relationship between vitamin D level and CDI recurrence. Materials and Methods: A retrospective chart review was conducted for 112 patients with vitamin D level drawn within 3 months of CDI diagnosis. Recurrence, severity of disease, 30-day mortality, and course of CDI were assessed. Results: The vitamin D–deficient group included 56 patients, and the normal group included 56 patients. The mean age of vitamin D–deficient and –sufficient groups was 68 ± 15.7 and 71 ± 14.4 years, respectively. The mean 25(OH) D level in the deficient group was 11.7 ± 4.6 ng/mL, and it was 36.2 ± 16.2 ng/mL in the normal group. A longer course of diarrhea was apparent in the vitamin D–deficient group compared to the normal group: 6.1 days (95% confidence interval [CI], 4.9–7.2) vs 4.2 days (95% CI, 3.5–4.9; P = .01). Sepsis rate was 24% in vitamin D–deficient group and 13% in normal group (P = .03). There were no differences in CDI recurrence, length of stay, severity of illness, and mortality with respect to vitamin D status. Conclusion: There may be an association between course of diarrhea and increased rate of sepsis in vitamin D–deficient CDI patients.