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Clostridium difficile Among Hospitalized Patients Receiving Antibiotics A Case-Control Study

Published online by Cambridge University Press:  21 June 2016

Scott Modena ,
Dilip Bearelly ,
Kenneth Swartz  and
Frank K. Friedenberg
Scott Modena
Affiliation:
Gastroenterology Section, Temple University Hospital
Dilip Bearelly
Affiliation:
Gastroenterology Section, Temple University Hospital
Kenneth Swartz
Affiliation:
Fox School of Business and Management, Temple University, Philadelphia, Pennsylvania
Frank K. Friedenberg*
Affiliation:
Gastroenterology Section, Temple University Hospital
*
Gastroenterology, Temple University Hospital, 8 Parkinson Pavilion, 3401 North Broad Street, Philadelphia, PA 19140., [email protected]
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Abstract

Objectives:

Clostridium difficile is the most common cause of infectious nosocomial diarrhea and can be found in up to 30% of asymptomatic hospitalized patients. Our primary aim was to compare the clinical characteristics of hospitalized patients who received antibiotics and developed C. difficile-associated diarrhea (CDAD) with those of hospitalized patients who received antibiotics and did not develop the disease.

Design:

Case-control study comprising inpatients at a single institution.

Patients:

Case-patients were defined as patients who had diarrhea and tested positive for C. difficile. Control-patients (matched 4:1 to case-patients) were defined as patients who received antibiotics for at least 5 days and did not develop CDAD.

Results:

On univariate analysis, nine variables were associated with CDAD. Only three of the variables, need for intensive care, length of stay, and macrolide antibiotic use, were found to be significant (P < .05) on logistic regression analysis. The odds ratios for status as a CDAD case were 3.68 (CI95, 1.44 to 9.40) for stay in the intensive care unit and 1.03 (CI95, 1.02 to 1.05) for each day of hospital stay. Receipt of macrolide antibiotics reduced risk significantly; the odds ratio was 0.23 (CI95, 0.19 to 0.87).

Conclusions:

We identified need for intensive care and length of stay as important risk factors for the development of CDAD. We also identified macrolide antibiotic use as protective against its development. Patients receiving intensive care may represent a population to study for targeted prophylaxis.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 26 , Issue 8 , August 2005 , pp. 685 - 690
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2005

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