Risk factors for Clostridium difficile infections in hospitalized patients

Background and objectives: To identify risk factors, and to estimate the crude effects attributable to hospital acquired Clostridium difficile infection (CDI). Patients and methods: Case-control study matched by age, gender, and admission date. Patient and healthcare risk factors were evaluated. Hospital stays and mortality were compared. Results: Thirty-eight cases and 76 controls were included (mean age 73 years). Cases presented worse Charlson index (P .02), higher pre-infection stay (median 10 vs. 5.5 days) and had received antibiotic treatment more frequently (89.5 vs. 40.7%) than their control counterparts. Albuminemia <3.5 gr/dL (OR 7.1; 1.4-37), having received cephalosporins (OR 10.1:1.8-55.1), quinolones (OR 9.4; 1.1-41.1), or proton pump inhibitors (OR 6.6; 1.1-41.1) were associated with an independent higher risk of CDI. Total hospital stay (31 vs. 5.5 days), as well as crude mortality, was higher for cases than for control patients (31.6 vs. 6.6%). Conclusions: Receiving cephalosporins, quinolones and proton pump inhibitors, as well as hyponutrition, increase the risk of CDI. CDI is associated with relevant crude effects on mortality and excess of stay. (C) 2010 Elsevier Espana, S.L. All rights reserved.