Risk factors for and estimated incidence of community-associated Clostridium difficile infection, North Carolina, USA

We determined estimated incidence of and risk factors for community-associated Clostridium difficile infection (CA-CDI) among patients treated at 6 North Carolina hospitals. CA-CDI case-patients were defined as adults (>18 years of age) with a positive stool test result for C. difficile toxin and...

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Bibliographic Details
Published in:Emerging infectious diseases 2010-02, Vol.16 (2), p.197-204
Main Authors: KUTTY, P.K, WOODS, C.W, SENA, A.C, BENOIT, S.T, NAGGIE, S, FREDERICK, J, EVANS, S, ENGEL, J, MCDONALD, L.C
Format: Article
Language:English
Subjects:
Adult
Age Distribution
Aged
Aged, 80 and over
Anti-infective agents
bacteria
Bacterial Proteins - analysis
Bacterial Toxins - analysis
Biological and medical sciences
Case-Control Studies
Clostridium difficile
Clostridium Infections - epidemiology
community
Community-Acquired Infections - epidemiology
Dysentery - epidemiology
enteric infections
Enterotoxins - analysis
Feces - chemistry
Female
Health aspects
Heart failure
Humans
Incidence
Infection
Male
Medical research
Medical sciences
Medicine, Experimental
Middle Aged
Miscellaneous
North Carolina - epidemiology
Odds Ratio
Prejudice
Public health. Hygiene
Public health. Hygiene-occupational medicine
Risk Factors
Veterans
Young Adult
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Summary:We determined estimated incidence of and risk factors for community-associated Clostridium difficile infection (CA-CDI) among patients treated at 6 North Carolina hospitals. CA-CDI case-patients were defined as adults (>18 years of age) with a positive stool test result for C. difficile toxin and no hospitalization within the prior 8 weeks. CA-CDI incidence was 21 and 46 per 100,000 person-years in Veterans Affairs (VA) outpatients and Durham County populations, respectively. VA case-patients were more likely than controls to have received antimicrobial drugs (adjusted odds ratio [aOR] 17.8, 95% confidence interval [CI] 6.6-48] and to have had a recent outpatient visit (aOR 5.1, 95% CI 1.5-17.9). County case-patients were more likely than controls to have received antimicrobial drugs (aOR 9.1, 95% CI 2.9-28.9), to have gastroesophageal reflux disease (aOR 11.2, 95% CI 1.9-64.2), and to have cardiac failure (aOR 3.8, 95% CI 1.1-13.7). Risk factors for CA-CDI overlap with those for healthcare-associated infection.
ISSN:1080-6040
1080-6059
DOI:10.3201/eid1602.090953