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Characteristics and Antibiotic Use Associated With Short-Term Risk of Clostridium difficile Infection Among Hospitalized Patients. Am J Clin Pathol 2015 Jun;143(6):895-900

Date

05/15/2015

Pubmed ID

25972333

Pubmed Central ID

PMC4630028

DOI

10.1309/AJCP9EWI6QPVTPQY

Scopus ID

2-s2.0-84937965182 (requires institutional sign-in at Scopus site)   12 Citations

Abstract

OBJECTIVES: Polymerase chain reaction (PCR) has been shown to have an excellent sensitivity and specificity for the detection of Clostridium difficile infection (CDI). Little is known about risk factors for CDI within 14 days of an initial negative test. We sought to determine the characteristics among hospitalized patients associated with risk of short-term acquisition of CDI.

METHODS: A case-control study was conducted. Cases were patients who converted from PCR negative to positive within 14 days. Each case was matched with three controls. Conditional logistic regression was used to estimate the association between patient characteristics and CDI.

RESULTS: Of the 30 patients in our study who had a positive PCR within 14 days of a first negative PCR (cases), 15 (50%) occurred within 7 days of the initial test. Cases had a higher proportion of intravenous vancomycin use in the previous 8 weeks (odds ratio [OR], 3.38; 95% confidence interval [CI], 1.34-8.49) and were less likely to have recent antiviral agent use (OR, 0.30; 95% CI, 0.11-0.83) compared with controls.

CONCLUSIONS: In hospitalized patients, treatment with intravenous vancomycin within the prior 8 weeks of a first negative PCR test for C difficile is a risk factor for short-term risk for hospital-acquired CDI. Repeat testing guidelines for C difficile PCR should take into consideration patients who may be at high risk for short-term acquisition of CDI.

Author List

Aldrete Sdel M, Magee MJ, Friedman-Moraco RJ, Chan AW, Banks GG, Burd EM, Kraft CS

Author

Sol Del Mar Aldrete MD Assistant Professor in the Medicine department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adult
Aged
Aged, 80 and over
Case-Control Studies
Cross Infection
Enterocolitis, Pseudomembranous
Female
Humans
Inpatients
Male
Middle Aged
Polymerase Chain Reaction
Risk Factors
Vancomycin