The role of physical proximity in nosocomial diarrhea.
To examine physical proximity as a risk factor for the nosocomial acquisition of Clostridium difficile-associated diarrhea (CDAD) and of antibiotic-associated diarrhea (AAD), we assessed a retrospective cohort of 2859 patients admitted to a community hospital from 1 March 1987 through 31 August 1987. Of these patients, 68 had nosocomial CDAD and 54 had nosocomial AAD. In multivariate analysis, physical proximity to a patient with CDAD (relative risk [RR], 1.86; 95% confidence interval [CI], 1.06-3.28), exposure to clindamycin (RR, 4.22; 95% CI, 2.11-8.45), and the number of antibiotics taken (RR, 1.49; 95% CI, 1.23-1.81) were significant. For patients with nosocomial AAD, exposure to a roommate with AAD (RR, 3.94; 95% CI, 1. 27-12.24), a stay in an intensive care unit or cardiac care unit (RR, 1.93; 95% CI, 1.05-3.53), and the number of antibiotics taken (RR, 2.01; 95% CI, 1.67-2.40) were significant risk factors. Physical proximity may be an independent risk factor for acquisition of nosocomial CDAD and AAD.
Chang
V T
VT
Department of Medicine, Veterans Affairs New Jersey Health Care System at East Orange/University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, NJ 07019, USA. victor.chang@med. va.gov
Nelson
K
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D016360:Clostridioides difficile; D003015:Clostridium Infections / Q000382:microbiology; D015331:Cohort Studies; D003428:Cross Infection / Q000382:microbiology*; D003967:Diarrhea / Q000139:chemically induced / Q000382:microbiology*; D004781:Environmental Exposure; D005260:Female; D006764:Hospitals, Community / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012307:Risk Factors
D000900:Anti-Bacterial Agents