Risk factors for Clostridium difficile toxin-positive nosocomial diarrhoea.
Data were retrieved from the records of all patients from whom stool was sent for Clostridium difficile toxin testing during the year 2001. Toxin-positive and -negative patients were compared by bivariate analysis and regression models. Eight hundred samples from 610 patients were sent for C. difficile toxin testing. Charts of 535 patients (88%) were available for analysis. Of those, 17% had a positive toxin test whilst 83% had a negative toxin test. There was no difference in the number of daily bowel movements between the two groups. Toxin-positive patients were older (P<0.0001), more often came from nursing homes (P<0.05), had higher leukocyte counts (P<0.001), higher blood urea nitrogen (P<0.01), lower serum albumin (P<0.01) and more often received diuretics (P<0.01) and clindamycin (P<0.05). Logistic regression analysis showed that previous antibiotic-associated diarrhoea was the most significant risk factor for toxin-positive diarrhoea (P<0.001), followed by clindamycin treatment (P<0.005), diuretics (P<0.005) and older age (P<0.05). Another logistic model showed the contribution of macrolides (P<0.05) to the development of hospital-acquired diarrhoea.
Raveh
David
D
Infectious Diseases Unit, Shaare Zedek Medical Center, Jerusalem, Israel. ravehmed@hotmail.com
Rabinowitz
Bella
B
Breuer
Gabriel S
GS
Rudensky
Bernard
B
Yinnon
Amos M
AM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects; D001427:Bacterial Toxins / Q000032:analysis*; D002648:Child; D002675:Child, Preschool; D016360:Clostridioides difficile / Q000472:pathogenicity*; D003015:Clostridium Infections / Q000209:etiology* / Q000382:microbiology; D003428:Cross Infection / Q000209:etiology* / Q000382:microbiology; D003967:Diarrhea / Q000382:microbiology*; D004761:Enterocolitis, Pseudomembranous / Q000209:etiology / Q000382:microbiology; D005243:Feces / Q000382:microbiology*; D005260:Female; D006761:Hospitals; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes; D011247:Pregnancy; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors
D000900:Anti-Bacterial Agents; D001427:Bacterial Toxins