title: Risk factors for Clostridium difficile infection in hemato-oncological patients: A case control study in 144 patients.
abstract: Evidence on risk factors for Clostridium difficile infection (CDI) in hemato-oncologic patients is conflicting. We studied risk factors for CDI in a large, well-characterized cohort of hemato-oncological patients. 144 hemato-oncological patients were identified in this retrospective, single center study with a microbiologically confirmed CDI-associated diarrhea. Patients were compared with 144 age and sex matched hemato-oncologic patients with CDI negative diarrhea. Risk factors such as prior antimicrobial therapy, type of disease, chemotherapy and survival were evaluated. CDI-positive patients received more frequently any antimicrobial agent and antimicrobial combination therapy than CDI-negative patients (79% vs. 67%; OR = 2.26, p = 0.038 and OR = 2.62, p = 0.003, respectively). CDI positive patients were treated more frequently with antimicrobial agents active against C. difficile than CDI negative ones (25% vs. 13%; OR = 2.2, p = 0.039). The interval between last chemotherapy and onset of diarrhea was significantly shorter in patients without CDI (median, 17 days vs 36 days; p < 0.001). Our study demonstrates that chemotherapy is not a significant risk factor for CDI but for early onset CDI negative diarrhea. The predominant modifiable risk factor for CDI is in hemato-oncological patients antimicrobial treatment. These findings should be taken into account in the daily clinical practice to avoid CDI associated complications and excess health care costs.
authors: Department of Internal Medicine I, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria.
authors: Thorsten
authors: T
authors: Fuereder
authors: Department of Internal Medicine I, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria.
authors: Danjel
authors: D
authors: Koni
authors: Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria.
authors: Andreas
authors: A
authors: Gleiss
authors: Institute for Enviromental Health, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria.
authors: Michael
authors: M
authors: Kundi
authors: Department of Laboratory Medicine, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria.
authors: Athanasios
authors: A
authors: Makristathis
authors: Department of Internal Medicine I, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria.
authors: Christoph
authors: C
authors: Zielinski
authors: Department of Internal Medicine I, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria.
authors: Christoph
authors: C
authors: Steininger
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016022:Case-Control Studies; D003015:Clostridium Infections / Q000188:drug therapy / Q000453:epidemiology*; D003428:Cross Infection / Q000382:microbiology; D003967:Diarrhea / Q000382:microbiology*; D004358:Drug Therapy; D004359:Drug Therapy, Combination; D005260:Female; D019337:Hematologic Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents