Incidence of Clostridium difficile Infection Detected by Premier Toxin A and B Enzyme Linked Immunosorbent Assay and Underlying Risk Factors in Patients Admitted to a University Hospital in Northern India

Abstract

Background: Clostridium difficile is a toxin-producing, Gram-positive, spore-forming anaerobic Bacilli isolated from air, water, soil, and human and animal feces. This study was performed to recognize the incidence of C. difficile infection (CDI) at this center by detecting toxigenic C. difficile using Premier Toxin A and B Enzyme linked immunosorbent assay (ELISA) from stool samples. Materials and Methods: A retrospective study was performed in the department of microbiology for 1 year from January 1, 2022 to December 31, 2022. All data were extracted from ward files, hospital electronic records, and laboratory registers. Statistical analysis was aided by the software program IBM SPSS Statistics version 20.0 (IBM Corp., Armonk, NY, USA). Results: We included 788 stool samples from patients with suspected CDI. The incidence of CDI at our center was 15.73% (124/788, 15.73%) based on C. difficile toxin positivity by Premier Toxin A and B ELISA. The mean age of patients was 37.83 ± 20.82 years with a male predominance (78/124, 62.9%). Patients with hypertension, and Type 2 diabetes mellitus (DM) patients were significantly associated with patients without inflammatory bowel disease. Pseudomembranous colitis was significant in patients not receiving appropriate antibiotics. Among underlying comorbidities, Type 2 DM, chronic kidney disease, patients undergoing hemodialysis, and solid organ transplant patients were significantly associated with patients not receiving appropriate antibiotics. The length of hospitalization was significantly prolonged in the cohort not receiving appropriate antibiotics. Conclusion: We have demonstrated the rate of CDI and associated risk factors to guide clinicians in implementing appropriate treatment to reduce the length of hospitalization in these patients.