Risk factors for Clostridium difficile infection in the community: a case-control study in patients in general practice, Denmark, 2009-2011.
To identify risk factors for Clostridium difficile infection (CDI) in Danish patients consulting general practice with gastrointestinal symptoms, a prospective matched case-control study was performed; cases (N = 259) had positive cultures for toxigenic C. difficile and controls (N = 455) negative cultures. Data were analysed by conditional logistic regression. In patients aged ⩾2 years (138 cases), hospitalization [odds ratio (OR) 8·4, 95% confidence interval (CI) 3·1-23], consumption of beef (OR 5·5, 95% CI 2·0-15), phenoxymethylpenicillin (OR 15, 95% CI 2·7-82), dicloxacillin (OR 27, 95% CI 3·6-211), and extended spectrum penicillins (OR 9·2, 95% CI 1·9-45) were associated with CDI. In patients aged <2 years none of these were associated with CDI, but in a subgroup analysis contact with animals was associated with CDI (OR 8·1, 95% CI 1·0-64). This study emphasizes narrow-spectrum penicillins, and suggests beef consumption, as risk factors for CDI in adults, and indicates a different epidemiology of CDI in infants.
Department of Microbiology and Infection Control, Statens Serum Institut, Copenhagen,Denmark.
L M
LM
Søes
Department of Clinical Microbiology,Odense University Hospital,Odense,Denmark.
H M
HM
Holt
Department of Microbiological Diagnostics and Virology, Statens Serum Institut, Copenhagen,Denmark.
B
B
Böttiger
Department of Microbiology and Infection Control, Statens Serum Institut, Copenhagen,Denmark.
H V
HV
Nielsen
Department of Science, Systems and Models,Roskilde University,Roskilde,Denmark.
V
V
Andreasen
Department of Clinical Microbiology,Odense University Hospital,Odense,Denmark.
M
M
Kemp
Department of Microbiology and Infection Control, Statens Serum Institut, Copenhagen,Denmark.
K E P
KE
Olsen
Department of Infectious Disease Epidemiology, Statens Serum Institut, Copenhagen,Denmark.
S
S
Ethelberg
Department of Infectious Disease Epidemiology, Statens Serum Institut, Copenhagen,Denmark.
K
K
Mølbak
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D016360:Clostridioides difficile / Q000302:isolation & purification*; D003015:Clostridium Infections / Q000453:epidemiology*; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000382:microbiology; D003718:Denmark / Q000453:epidemiology; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005260:Female; D058006:General Practice / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D055815:Young Adult
D000900:Anti-Bacterial Agents