University of Oulu

Marttila-Vaara, M., Ylipalosaari, P. & Kauma, H. Clostridium difficile infections in teaching hospital in northern Finland. BMC Infect Dis 19, 48 (2019).

Clostridium difficile infections in teaching hospital in northern Finland

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Author: Marttila-Vaara, M.1; Ylipalosaari, P.2; Kauma, H.1
Organizations: 1Research unit of Internal Medicine, Oulu University Hospital and University of Oulu, Oulu, Finland
2Department of Infection Control, Oulu University Hospital, Box PL 20 FIN-90029 OYS, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.5 MB)
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Language: English
Published: Springer Nature, 2019
Publish Date: 2020-03-24


Background: The aim of this study to compare the incidence of Clostridium difficile (CD) infections in the five university hospital districts in Finland based on national register. The clinical findings of CD cases in the Oulu University Hospital (OUH) in one-year cohort were also analyzed.

Methods: The numbers of the CD cases from the national register were used for the hospital district comparison. A retrospective cohort study was conducted among all adult (> 16 years) patients treated in the OUH in 2013, who had positive CD toxin B gene test in stools. The selection of the cohort was based on the data from the OUH microbiology laboratory and the clinical characteristics were collected from hospital records.

Results: The incidence of CD findings in 2013 was higher in the OUH district than in the other four university hospital districts: 159 vs. 70 to 84 per 100,000 inhabitants. In 2013, 261 patients had CD infection treated in the OUH. The yearly number of CD cases treated in the OUH in 2009–2016 varied between 221 and 287, and the corresponding proportion of positive CD findings out of all samples taken varied from 10.0 to 17.8%. A recurrent infection was seen in 58 patients (22%) while the all-cause 30 day mortality was 7.3%.

Conclusions: Diagnostic strategies differed nationally, which may explain the differences in CD incidence between the university hospital districts. In the OUH, no increase in the number of CD infections was seen in 2009–2016. Main characteristics of the patient cohort in the OUH were in harmony with earlier literature.

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Series: BMC infectious diseases
ISSN: 1471-2334
ISSN-E: 1471-2334
ISSN-L: 1471-2334
Volume: 19
Article number: 48
DOI: 10.1186/s12879-018-3663-y
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
Funding: Grant from Astellas Pharma (number T74263). The funding body did not have any role in the design of this study, data collection or analysis and interpretation of the data. One of the authors (PY) was on the study leave when writing the preliminary manuscript.
Copyright information: © The Author(s). 2019. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.