Risk Factors of Patients With Diarrhea for Having Clostridioides (Clostridium) difficile Infection

• Published in: Frontiers in microbiology 2022-03, Vol.13, p.840846-840846
• Main Authors: Lang, Vanessa, Gunka, Katrin, Ortlepp, Jan Rudolf, Zimmermann, Ortrud, Groß, Uwe
• Format: Article
• Language: English
• Subjects: antibiotic; Clostridioides difficile; Clostridium difficile; Microbiology; nosocomial infection; proton pump inhibitor; risk factor
• ISSN: 1664-302X; 1664-302X
• DOI: 10.3389/fmicb.2022.840846

Nosocomial infections with have become an emergent health threat. We sought to define risk factors for a infection (CDI) beyond the widely known ones, such as antibiotic use and prior hospital stay. We therefore focused on a group of patients with diarrhea in order to identify risk factors for infection among this symptomatic cohort. A total of 121 hospitalized patients from Seesen/Germany with diarrhea were included who submitted a stool sample and were interviewed about their socio-demographic background, lifestyle and state of health using a standardized questionnaire. Antibiotic potential of diuretics was examined by agar diffusion test. was identified in 29 patients resulting in a prevalence of 24.0%. The infection was hospital-acquired in most cases ( < 0.001, 82.1%; = 23/28, versus 29/91, 31.9%). The generally accepted risk factor previous antibiotic use was confirmed in this study ( = 0.002, = 23/28 CDI patients, 82.1%, versus = 44/91 non-CDI patients, 48.4%). The following additional risk factors were identified: regular consumption of proton pump inhibitors; PPI ( = 0.011, = 24/29, 82.8% vs. = 52/92, 56.5%), CDI patients ate less vegetables ( = 0.001, = 12/29, 41.4% vs. 69/92, 75.0%). The intake of the diuretic agent torasemid in patients with CDI ( = 0.005, = 18/29, 62.1%) was higher than in patients without ( = 30/92, 32.6%). More patients with CDI had to undergo a surgery in the previous year ( = 0.022, = 13/29, 44.8% vs. = 21/92, 22.8%) and held more birds ( = 0.056, = 4/29, 13.8%) than individuals of the negative group ( = 3/92, 3.3%). In conclusion, although no antibiotic potential was detected in diuretics, especially torasemid seems to have significant influence for the occurrence of a CDI as well as a nutrition poor in vegetables. A diet rich in vegetables represented a fourfold lower risk for a CDI (OR 0.240, CI (0.0720 - 0.796]).