931. The Epidemiology of Clostridium difficile Infections among Oncology Patients
Session: Poster Abstract Session: Clostridium difficile Infections: Epidemiology and Diagnostics
Friday, October 9, 2015
Room: Poster Hall
Posters
  • IDWeek - Poster V2.pdf (1.9 MB)
  • Background: Clostridium difficile infection (CDI) is the leading cause of hospital-acquired diarrhea. Oncology patients are at increased risk for CDI though knowledge of the epidemiology of CDI in this population is limited. The primary objective of this study was to describe the demographic factors, medical history, and clinical characteristics and identify risk factors for CDI among oncology patients. 

    Methods: A retrospective, case-control study was performed. Seventy-seven CDI cases were compared to two control groups; one control group of oncology patients with diarrhea but whose stool samples were tested and were negative for CDI (n=77), and a second control group of patients matched to cases based on hospital ward and date of discharge (n=152). Multivariate analyses were performed using logistic regression including variables associated with CDI in univariate analysis. 

    Results: Days of hospitalization prior to test (OR=1.056, 95% CI 1.016, 1.099), fever on test date (OR=3.915, 95% CI 1.184, 12.940), and history of CDI (OR=20.895, 95% CI 2.475, 176.430) were significantly associated with CDI in cases compared to the negative test control group. When cases were compared to the matched control group, age (OR=1.047, 95% CI 1.013, 1.082), beta-lactams/beta-lactamase inhibitors (BL/BLI) (OR=2.643, 95% CI 1.229, 5.683), recent blood transfusion (OR=2.328, 95% CI 1.061, 5.107), history of CDI (OR=31.301, 95% CI 2.478, 395.312), and prior receipt of cephalosporins (OR=2.097, 95% CI 1.006, 4.369) and metronidazole (OR=5.492, 95% CI 2.014, 14.976) were significantly associated with CDI.

    Conclusion: Clinical parameters such as fever, days of hospitalization prior to testing, and history of CDI are associated with CDI among tested patients. These variables may be used to increase the yield of CDI testing and empiric CDI treatment. Based on the analysis of the matched control group, reduction in cephalosporin, BL/BLI and metronidazole use, particularly among older patients and those with a history of CDI, recent blood transfusions, or other CDI risk factors, may reduce the risk of CDI in this patient population and should be a focus of future study and intervention.

    Yunyoung Gina Chang, M.P.H., Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, Louise Dembry, MD, MS, MBA, FSHEA, Qiss, Yale University School of Medicine/YNHH, New Haven, CT and David Banach, M.D., M.P.H., M.S., Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT

    Disclosures:

    Y. G. Chang, None

    L. Dembry, None

    D. Banach, None

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