title: Epidemiology and outcome of Clostridium difficile infection and diarrhea in HIV infected inpatients.
abstract: Clostridium difficile causes diarrhea in HIV infected patients but reports of prevalence, risk factors, and outcome vary. We studied the impact of C. difficile in 161 HIV infected inpatients admitted to Cook County Hospital. Patients with C. difficile had more hospital admissions in the previous 6 months (p =.04), spent more days in the hospital in the previous 3 months (p =.02), more often had previously received H2 blockers or treatment for Pneumocystis carinii (p <.05), and had a more frequent history of herpesvirus (p =.03) or opportunistic infections (p =.04). C. difficile associated diarrhea (CDAD) was the etiology in 32% of all study patients with diarrhea. Patients with CDAD were hospitalized for longer periods (p =.02) and received more antibiotics (p =.002). C. difficile was frequently present in our HIV infected patients, especially those with advanced HIV disease, but appeared to have little impact on morbidity or mortality.
authors.affiliation: Cook County Hospital, Rush Medical College, Hektoen Institute, Chicago, Illinois, USA. Jpulvir@hektoen.org
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Pulvirenti
authors.forename: Tarun
authors.initials: T
authors.lastname: Mehra
authors.forename: Irfan
authors.initials: I
authors.lastname: Hafiz
authors.forename: Patricia
authors.initials: P
authors.lastname: DeMarais
authors.forename: Dayle
authors.initials: D
authors.lastname: Marsh
authors.forename: Frank
authors.initials: F
authors.lastname: Kocka
authors.forename: Peter M
authors.initials: PM
authors.lastname: Meyer
authors.forename: Staci A
authors.initials: SA
authors.lastname: Fischer
authors.forename: Larry
authors.initials: L
authors.lastname: Goodman
authors.forename: Dale N
authors.initials: DN
authors.lastname: Gerding
authors.forename: Robert A
authors.initials: RA
authors.lastname: Weinstein
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology* / Q000382:microbiology; D000293:Adolescent; D000328:Adult; D016360:Clostridioides difficile / Q000502:physiology*; D003967:Diarrhea / Q000150:complications* / Q000453:epidemiology*; D004761:Enterocolitis, Pseudomembranous / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000382:microbiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors