title: Risk factors for Clostridium difficile-associated diarrhea and the effectiveness of prophylactic probiotic therapy.
abstract: Measures for prevention of Clostridium difficile-associated diarrhea, a common nosocomial infection, in hospital settings are urgently needed. This study was conducted to identify the risk factors contributing to C. difficile-associated diarrhea and to evaluate the clinical benefit of probiotics in its prevention. The study included 2716 patients at least 20 years old who received an injected antibiotic at any time between February 2010 and February 2011; a total of 2687 patients (98.9%) were assigned to the non-C. difficile-associated diarrhea group, and 29 patients (1.1%) were assigned to the C. difficile-associated diarrhea group. Univariate analysis revealed a significant difference between the two groups for the following factors: antibiotic therapy for > or = 8 days; enteral nutrition; intravenous hyperalimentation; fasting; proton pump inhibitor use; H2 blocker use; and serum albumin < or = 2.9g/dL (p<0.05). Multivariate logistic regression analysis revealed a significant difference between the two groups for several factors. Antibiotic therapy for > or = 8 days, intravenous hyperalimentation, proton pump inhibitor use, and H2 blocker use were therefore shown to be risk factors for C. difficile-associated diarrhea. Prophylactic probiotic therapy was not shown to suppress the occurrence of C. difficile-associated diarrhea.
authors.affiliation: Department of Pharmacy, Gifu Municipal Hospital, Gifu, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Mizui
authors.forename: H
authors.initials: H
authors.lastname: Teramachi
authors.forename: T
authors.initials: T
authors.lastname: Tachi
authors.forename: K
authors.initials: K
authors.lastname: Tamura
authors.forename: H
authors.initials: H
authors.lastname: Shiga
authors.forename: N
authors.initials: N
authors.lastname: Komada
authors.forename: M
authors.initials: M
authors.lastname: Umeda
authors.forename: A
authors.initials: A
authors.lastname: Koda
authors.forename: S
authors.initials: S
authors.lastname: Aoyama
authors.forename: C
authors.initials: C
authors.lastname: Goto
authors.forename: T
authors.initials: T
authors.lastname: Tsuchiya
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D016360:Clostridioides difficile; D003428:Cross Infection / Q000517:prevention & control; D003967:Diarrhea / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control*; D004750:Enteral Nutrition / Q000009:adverse effects; D004761:Enterocolitis, Pseudomembranous / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control*; D005260:Female; D006635:Histamine H2 Antagonists / Q000009:adverse effects; D006801:Humans; D016015:Logistic Models; D008297:Male; D019936:Probiotics / Q000627:therapeutic use*; D054328:Proton Pump Inhibitors / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D000900:Anti-Bacterial Agents; D006635:Histamine H2 Antagonists; D054328:Proton Pump Inhibitors