354. Evaluation of Risk Factors for Recurrent Clostridium difficile Infection in Hospitalized Patients
Session: Poster Abstract Session: Clostridium difficile - Epidemiology, Diagnosis, Treatment, and Prevention
Friday, October 21, 2011
Room: Poster Hall B1

Clostridium difficile infection (CDI) is the most common cause of hospital acquired infectious diarrhea. Recurrent CDI is seen in 10% - 40% of patients, despite recommended treatment of the initial episode. Early detection and treatment of recurrent CDI remains challenging. Identifying patients at risk for recurrent CDI will promote prevention and prompt early treatment of recurrence in high-risk patients, and thus should lead to a decrease in morbidity and mortality. The aim of this study is to evaluate risk factors of recurrent CDI in hospitalized patients.


We retrospectively analyzed 166 cases of CDI in a community hospital between January 2005 and December 2008. Ninety of 166 patients met enrollment criteria. We compared patients with recurrent CDI to patients without recurrent infection. We reviewed patient demographics, co-morbidities, including Charlson co-morbidity index, general laboratory data, antibiotic exposure, and antibiotic treatment for the first episode of CDI, as well as known risk factors for recurrent CDI. A multivariate logistic regression model was used to determine risk factors of recurrent CDI.


Of the 90 patients, 62 (68.9 %) were women and sixty-six patients (73.3%) were older than age sixty-five. Thirty-four patients (37.8%) were nursing home residents. Twenty-eight (31.1 %) patients developed recurrent CDI. Exposure to two or more antibiotics (p=0.008), use of cephalosporin antibiotics (p=0.016), diverticulosis (p=0.031), and diabetes mellitus (p=0.033) were associated with recurrent CDI in univariant analysis. The logistic regression model suggested that cephalosporin use (OR, 3.2, 95% CI, 1-10.25) and diverticulosis (OR, 3.9, 95 % CI, 1.19-12.857) were independent predictors for recurrent CDI. 


Our findings suggest that diverticulosis and cephalosporin antibiotic use are independent risk factors for recurrent Clostridium difficile infection.

Subject Category: C. Clinical studies of bacterial infections and antibacterials including sexually transmitted diseases and mycobacterial infections (surveys, epidemiology, and clinical trials)

Aylin Colpan, MD1,2, Teshome Hailemichael, MD1, Daniel Assefa, MD1, David Livert, PhD1 and Roman Tuma, MD3, (1)Internal Medicine, Easton Hospital, Department of Internal Medicine, Drexel University, Easton, PA, (2)Department of Medicine, Division of Infectious Diseases and International Medicine, University of Minnesota, Minneapolis, MN, (3)Easton Hospital, Department of Internal Medicine, Section of Infectious Diseases., Easton, PA


A. Colpan, None

T. Hailemichael, None

D. Assefa, None

D. Livert, None

R. Tuma, None

Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.