title: Risk factors for and estimated incidence of community-associated Clostridium difficile infection, North Carolina, USA.
abstract: We determined estimated incidence of and risk factors for community-associated Clostridium difficile infection (CA-CDI) among patients treated at 6 North Carolina hospitals. CA-CDI case-patients were defined as adults (>18 years of age) with a positive stool test result for C. difficile toxin and no hospitalization within the prior 8 weeks. CA-CDI incidence was 21 and 46 per 100,000 person-years in Veterans Affairs (VA) outpatients and Durham County populations, respectively. VA case-patients were more likely than controls to have received antimicrobial drugs (adjusted odds ratio [aOR] 17.8, 95% confidence interval [CI] 6.6-48] and to have had a recent outpatient visit (aOR 5.1, 95% CI 1.5-17.9). County case-patients were more likely than controls to have received antimicrobial drugs (aOR 9.1, 95% CI 2.9-28.9), to have gastroesophageal reflux disease (aOR 11.2, 95% CI 1.9-64.2), and to have cardiac failure (aOR 3.8, 95% CI 1.1-13.7). Risk factors for CA-CDI overlap with those for healthcare-associated infection.
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
authors.forename: Preeta K
authors.initials: PK
authors.lastname: Kutty
authors.forename: Christopher W
authors.initials: CW
authors.lastname: Woods
authors.forename: Arlene C
authors.initials: AC
authors.lastname: Sena
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Benoit
authors.forename: Susanna
authors.initials: S
authors.lastname: Naggie
authors.forename: Joyce
authors.initials: J
authors.lastname: Frederick
authors.forename: Sharon
authors.initials: S
authors.lastname: Evans
authors.forename: Jeffery
authors.initials: J
authors.lastname: Engel
authors.forename: L Clifford
authors.initials: LC
authors.lastname: McDonald
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001426:Bacterial Proteins / Q000032:analysis; D001427:Bacterial Toxins / Q000032:analysis; D016022:Case-Control Studies; D003015:Clostridium Infections / Q000453:epidemiology*; D017714:Community-Acquired Infections / Q000453:epidemiology; D004403:Dysentery / Q000453:epidemiology*; D004768:Enterotoxins / Q000032:analysis; D005243:Feces / Q000737:chemistry; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009657:North Carolina / Q000453:epidemiology; D016017:Odds Ratio; D011287:Prejudice; D012307:Risk Factors; D014728:Veterans; D055815:Young Adult
chemical_list: D001426:Bacterial Proteins; D001427:Bacterial Toxins; D004768:Enterotoxins; C041348:tcdA protein, Clostridium difficile; C031815:toxB protein, Clostridium difficile