Affiliation:
1. Section of Infectious Diseases, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, 90035-903 Porto Alegre, RS, Brazil
2. Hospital Infection Control Committee, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, 90035-903 Porto Alegre, RS, Brazil
Abstract
Background. The epidemiology ofClostridium difficileinfection has changed over time. Therefore, it is essential to monitor the characteristics of patients at risk of infection and factors associated with poor prognosis.Objective. To evaluate factors associated withC. difficileinfection and with poor prognosis in those with documentedC. difficilecolitis.Methods. A retrospective case-control study of 75 patients with documentedC. difficilecolitis and 75 controls with hospital-acquired diarrhea of other causes. Stepwise multiple logistic regression was used to identify factors associated withC. difficileinfection among patients with hospital-acquired diarrhea.Results. Previous antibiotic treatment (odds ratio (OR), 13.3; 95% confidence interval (CI), 1.40–126.90), abdominal distension (OR, 3.85; 95% CI, 1.35–10.98), and fecal leukocytes (OR, 8.79; 95% CI, 1.41–54.61) are considered as predictors ofC. difficilecolitis; anorexia was negatively associated withC. difficileinfection (OR, 0.15; 95% CI, 0.03–0.66). Enteral tube feeding was independently associated with a composite outcome that included in-hospital mortality, intensive care unit admission, and treatment failure (OR, 3.75; 95%CI, 1.24–11.29).Conclusions. Previous antibiotic use and presence of fecal leukocytes in patients with hospital-acquired diarrhea are associated withC. difficilecolitis and enteral tube support with complications associated withC. difficilecolitis.
Funder
Conselho Nacional de Desenvolvimento Científico e Tecnológico
Subject
Gastroenterology,Hepatology
Cited by
16 articles.
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