Yuan-Pin Hung1, Jen-Chieh Lee2, Bo-Yang Tsai3, Jia-Ling Wu2, Hsiao-Chieh Liu4, Hsiu-Chuan Liu5, Hsiao-Ju Lin1, Pei-Jane Tsai6, Wen-Chien Ko7. 1. Department of Internal Medicine, Tainan Hospital, Ministry of Health & Welfare, Tainan, Taiwan; Department of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Graduate Institute of Clinical Medicine, National Health Research Institutes, Tainan, Taiwan. 2. Department of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan. 3. Institute of Basic Medical Sciences, National Cheng Kung University, Tainan, Taiwan. 4. Department of Internal Medicine, Tainan Hospital, Ministry of Health & Welfare, Tainan, Taiwan; Department of Experiment and Diagnosis, Tainan Hospital, Ministry of Health & Welfare, Tainan, Taiwan. 5. Department of Experiment and Diagnosis, Tainan Hospital, Ministry of Health & Welfare, Tainan, Taiwan. 6. Center of Infectious Disease and Signaling Research, National Cheng Kung University, Tainan, Taiwan; Department of Medical Laboratory Science and Biotechnology, Medical College, National Cheng Kung University, Medical College, Tainan, Taiwan; Department of Pathology, National Cheng Kung University Hospital, Tainan, Taiwan. 7. Department of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan. Electronic address: winston3415@gmail.com.
Abstract
BACKGROUND: Clostridium difficile is the leading cause of nosocomial infectious diarrhea. Hospitalized patients were at risk of C. difficile-associated diarrhea (CDAD). However the risk factors of CDAD in patients with different hospitalization period are not clear. MATERIAL AND METHODS: A prospective investigation was conducted in medical wards of a district hospital in southern Taiwan, from January 2011 to January 2013. We arbitrary divided patients into two groups: hospitalized for at most 14 days and 15-30 days, and analyzed their risk factors for CDAD. RESULTS: Overall 451 patients were enrolled. The multivariable analysis of 19 (8.0%) patients developing CDAD within 14 days' hospital stay and 216 patients hospitalized for ≤ 14 days without CDAD showed malignancy (odds ratio [OR] 7.15, 95% confidence interval [CI] 1.82-28.09; P = 0.005), prior cephalosporin (OR 10.8, 95% CI 1.3-93.9; P = 0.03) and proton pump inhibitor (PPI; OR 7.1, 95% CI 2.1-24.7; P = 0.002) therapy were independently related to CDAD (Table 3), but hypertension (OR 0.2, 95% CI 0.1-0.7; P = 0.01) was reversely related to CDAD. However, of 9 (4.2%) patients developing CDAD later (15-30 days' hospital stay) and 207 patients with longer hospitalization (15-30 days) but free of CDAD, malignancy (OR 14.0, 95% CI 1.6-124.9; P = 0.02) and underlying diabetes mellitus (OR 20.5, 95% CI 2.9-144.9; P = 0.002) were independent risk factors of CDAD. CONCLUSION: Risk factors for CDAD among hospitalized patients varied by the duration of hospital stay. Intervention strategies to prevent CDAD may be different in terms of hospital stay duration.
BACKGROUND:Clostridium difficile is the leading cause of nosocomial infectious diarrhea. Hospitalized patients were at risk of C. difficile-associated diarrhea (CDAD). However the risk factors of CDAD in patients with different hospitalization period are not clear. MATERIAL AND METHODS: A prospective investigation was conducted in medical wards of a district hospital in southern Taiwan, from January 2011 to January 2013. We arbitrary divided patients into two groups: hospitalized for at most 14 days and 15-30 days, and analyzed their risk factors for CDAD. RESULTS: Overall 451 patients were enrolled. The multivariable analysis of 19 (8.0%) patients developing CDAD within 14 days' hospital stay and 216 patients hospitalized for ≤ 14 days without CDAD showed malignancy (odds ratio [OR] 7.15, 95% confidence interval [CI] 1.82-28.09; P = 0.005), prior cephalosporin (OR 10.8, 95% CI 1.3-93.9; P = 0.03) and proton pump inhibitor (PPI; OR 7.1, 95% CI 2.1-24.7; P = 0.002) therapy were independently related to CDAD (Table 3), but hypertension (OR 0.2, 95% CI 0.1-0.7; P = 0.01) was reversely related to CDAD. However, of 9 (4.2%) patients developing CDAD later (15-30 days' hospital stay) and 207 patients with longer hospitalization (15-30 days) but free of CDAD, malignancy (OR 14.0, 95% CI 1.6-124.9; P = 0.02) and underlying diabetes mellitus (OR 20.5, 95% CI 2.9-144.9; P = 0.002) were independent risk factors of CDAD. CONCLUSION: Risk factors for CDAD among hospitalized patients varied by the duration of hospital stay. Intervention strategies to prevent CDAD may be different in terms of hospital stay duration.