Risk factors for Clostridium difficile-associated diarrhea on an adult hematology-oncology ward
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Nosocomial diarrhea caused by Clostridium difficile causes significant morbidity and mortality in an increasing proportion of hospitalized patients annually. This case-control study of patients admitted to the hematology-oncology ward of a tertiary academic medical center over a 2-year period demonstrates that patients with Clostridium difficile-associated diarrhea (CDAD) were 22 times more likely than ward-matched controls with diarrhea to have received any antibiotic either during hospitalization or in the month preceding admission (p < 0.005), and they were nearly three times as likely as controls to have received a cephalosporin during the same period (p < 0.005). Diarrhea among lung cancer patients was approximately three times more likely to be caused by this organism than to be due to other causes (p = 0.04). A trend towards CDAD patients receiving higher numbers of different antibiotics during hospitalization (3.3 vs. 2.6, 95%CI −1.42–0.02, p = 0.06) was noted. Administration of interleukin-2 either during hospitalization or in the 30 days preceding admission was seven times more likely to have occurred in CDAD cases (p = 0.04), raising the question of whether or not this agent increases risk.
KeywordsClostridium Difficile Infection Clostridium Difficile Antibiotic Exposure Stool Testing Special Care Unit
- 10.Sohn S, Climo M, Diekema D, Fraser V, Herwaldt L, Marino S, Noskin G, Perl T, Song X, Tokars J, Warren D, Wong E, Yokoe DS, Zembower T, Sepkowitz KA (2005) Varying rates of Clostridium difficile-associated diarrhea at prevention epicenter hospitals. Infect Cont Hosp Epidem 26:676–679CrossRefGoogle Scholar
- 12.Turgeon DK, Novicki TJ, Quick J, Carlson L, Miller P, Ulness B, Cent A, Ashley R, Larson A, Coyle M, Limaye AP, Cookson BT, Fritsche TR (2003) Six rapid tests for direct detection of Clostridium difficile and its toxins in fecal samples compared with the fibroblast cytotoxicity assay. J Clin Microbiol 41:667–670PubMedCrossRefGoogle Scholar
- 16.Daubener W et al (1988) Clostridium difficile toxins A and B inhibit human immune responses in vitro. Infect Immune 56:1107–1112Google Scholar