A new study shows that patients with low vitamin D levels who develop Clostridia difficile (C. diff) have a higher recurrence rate and possibly higher hospital mortality. C. diff is a bacterium that causes diarrhea and more serious intestinal conditions such as colitis, and often occurs after taking antibiotics.
Previous studies have shown that normal levels of vitamin D are associated with improved outcomes in hospitalized patients, and conversely, low levels of vitamin D have been associated with higher mortality rate in hospitalized patients. Investigators at New York Hospital Queens –Weill Cornell Medical College, led by Moshe Rubin, MD, director of gastroenterology, sought to determine whether vitamin D levels are associated with a persons' ability to resolve their infection.
Researchers tracked 83 patients who had been admitted to the hospital who were then diagnosed with C. diff. They measured vitamin D levels in all of the patients, then followed their hospital course. Researchers noted how many patients were still alive after 30 days, and compared the outcome of patients with normal vitamin D levels to those with low levels. They found that up to 40 percent of people, especially in an older age group with multiple illnesses, died from some cause if they developed C. diff during that hospitalization.
Furthermore, while they may not die from C. diff, Dr. Rubin said it definitely adds a major complication that contributes to high mortality.
Researchers found that those with normal levels of vitamin D had a higher resolution rate, and a lower recurrence rate than those with low vitamin D levels. These findings are consistent with what is currently understood about vitamin D — it plays a role in immune function, may be an important factor in fighting infection, low levels seem to be a marker for not resolving diseases in general and it is associated with higher mortality rates.
Sixty-two patients were tracked for 30 days; 45 percent had normal vitamin D levels while 55 percent had low vitamin D levels. In the normal vitamin D group, they found 53 percent remained disease-free for 30 days, but in the group with low vitamin D levels, only 26 percent resolved their C. diff infections. Dr. Rubin noted that since this study was observational, it does not prove a cause and effect relationship between vitamin D levels and recurrence of C. diff, but it does identify an association.
Dr. Rubin said that since the study sample was relatively small, it should be repeated with a larger patient population to corroborate the data.
"We're starting to understand the importance of vitamin D in relation to overall health and to particular infections, like C. diff," said Dr. Rubin. "It's important to pay attention to nutritional issues and possibly even supplement vitamin D in patients with low levels to help fight serious infections."
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