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.
Y. G. Chang,
D. Banach, None
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