Risk Factors of Clostridium difficile Infection in Hospitalized Patients With Diarrhea / 胃肠病学

ABSTRACT

Background: Clostridium difficile infection (CDI) is the most common cause of hospital-acquired diarrhea and an important cause of death in hospitalized patients with diarrhea. However, there are not sufficient clinical researches on the risk factors of CDI. Aims: To investigate the risk factors of CDI in hospitalized patients with diarrhea. Methods: A total of 230 hospitalized diarrhea patients who received Clostridium difficile test from January 2015 to January 2019 at the Second Hospital of Hebei Medical University were collected. The patients were divided into CDI group and non-CDI group. Logistic regression analysis was performed to investigate the risk factors of CDI. Results: Compared with non-CDI group, patients in CDI group had a longer hospital stay (P<0.05) and a higher proportion of surgery in the past 6 months (P<0.05). The number of comorbidities in CDI group was higher than that in non-CDI group (P<0.05), and the ratio of gastrointestinal disease, cardiovascular disease, blood/immune system disease, nervous system disease in CDI group were higher than those in non-CDI group (P<0.05). Multivariate analysis showed the number of comorbidities (OR=3.215, 95% CI 1.576-4.743; P=0.003), gastrointestinal disease (OR=4.135, 95% CI 3.048-11.416; P=0.000), surgical history (OR=6.734, 95% CI 2.692-15.849; P=0.000) and antibiotic use (OR=5.996, 95% CI 2.173-15.481; P=0.000) were risk factors of CDI, especially the use of quinolone antibiotics (OR=4.769, 95% CI 2.138-14.757; P=0.000). Conclusions: CDI can prolong the hospital stay of patients with diarrhea. Number of comorbidities, underlying gastrointestinal disease, recent history of surgery and antibiotic use, especially the use of quinolone antibiotics are risk factors of CDI in hospitalized patients with diarrhea.