Risk factors associated with Clostridium difficile diarrhea in hospitalized adult patients: a case-control study--sucralfate ingestion is not a negative risk factor.
OBJECTIVE
To assess risk factors associated with Clostridium difficile diarrhea in hospitalized adult patients, and to test the hypothesis that sucralfate ingestion is associated with nondetection of C difficile cytotoxin in stool specimens.


METHODS
A retrospective case-control study of hospitalized adult patients who had stool specimens assayed for C difficile cytotoxin. For each patient who had positive C difficile cytotoxin, a patient who had negative C difficile cytotoxin was used as a control. The study period was January to December 1993.


METHODS
A community teaching hospital affiliated with a medical school in northeastern Ohio.


RESULTS
There were 91 case patients and 91 control patients. Cephalosporin exposure was identified as a risk factor in patients with C difficile diarrhea. The number of patients who had sucralfate ingestion was comparable in both groups of patients.


CONCLUSIONS
Administration of cephalosporins was identified as a risk factor in patients with C difficile diarrhea. We were not able to confirm a recent report of the association between ingestion of sucralfate and nondetection of C difficile cytotoxin in stool specimens. Our findings suggest that sucralfate ingestion is not associated with nondetection of C difficile cytotoxin in stool specimens. Assay of C difficile cytotoxin in stool specimens remains a valid method of diagnosing C difficile diarrhea, even in patients who ingest sucralfate.
Watanakunakorn
P W
PW
Northeastern Ohio Universities College of Medicine, Rootstown, USA.
Watanakunakorn
C
C
Hazy
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D016360:Clostridioides difficile; D003967:Diarrhea / Q000453:epidemiology* / Q000382:microbiology; D004761:Enterocolitis, Pseudomembranous / Q000453:epidemiology* / Q000382:microbiology; D005243:Feces / Q000382:microbiology; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009820:Ohio; D013392:Sucralfate / Q000008:administration & dosage*
D013392:Sucralfate