title: Ambulatory-treated Clostridium difficile infection: a comparison of community-acquired vs. nosocomial infection.
abstract: The purpose of this study was to identify the clinical outcomes of ambulatory-treated Clostridium difficile infection (CDI) and risk factors associated with community-associated CDI (CA-CDI). Adult patients diagnosed with CDI in the institutional or ambulatory-care setting between 1 April 2005 and 30 April 2011, with no other CDI diagnosis in the previous 180 days, and who purchased an ambulatory, anti-CDI agent within 7 days of CDI diagnosis were included. A total of 1201 patients were included with 914 (76%) and 287 (24%) identified with CA-CDI and nosocomial CDI (N-CDI), respectively. Patients with N-CDI were more likely to have had a recurrent CDI (P = 0·043) and died from any cause (P < 0·001). Patients with CA-CDI were younger, healthier, and had fewer traditional risk factors compared to patients with N-CDI. To prevent CA-CDI, clinicians should be aware that patients at risk for CA-CDI are unique from those at risk for N-CDI.
authors: Pharmacy Department,Kaiser Permanente Colorado, Aurora, CO & Skaggs School of Pharmacy, University of Colorado Anschutz Medical Campus, Aurora, CO,USA.
authors: T
authors: T
authors: Delate
authors: Pharmacy Department,Exempla Saint Joseph Hospital,Denver, CO,USA.
authors: G
authors: G
authors: Albrecht
authors: Skaggs School of Pharmacy,University of Colorado Medical Campus, Aurora, CO,USA.
authors: K
authors: K
authors: Won
authors: Pharmacy Department,Kaiser Permanente Colorado, Denver, CO,USA.
authors: A
authors: A
authors: Jackson
mesh_terms: D000368:Aged; D000553:Ambulatory Care / Q000379:methods; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016360:Clostridioides difficile; D017714:Community-Acquired Infections / Q000188:drug therapy; D003428:Cross Infection / Q000188:drug therapy*; D003967:Diarrhea / Q000188:drug therapy / Q000382:microbiology; D004761:Enterocolitis, Pseudomembranous / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D000900:Anti-Bacterial Agents
keywords: public health