Case-control study of Clostridioides difficile in a rural health care area.

Cristina Muñoz Cuevas, María Ángeles Asencio Egea, María Franco Huerta, María Huertas Vaquero, Ángel Arias Arias, Rafael Carranza González

Gastroenterologia y hepatologia 2023 Jan

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To determine the risk and prognostic factors for Clostridioides difficile infection (CDI). Prospective, case-control study with 61 cases and 64 controls, aged ≥2 years with diarrhoea, carried out in Castilla-La Mancha Health Care Area for 14 months. The diagnosis was made by immunochromatography technics (glutamate dehydrogenase and toxin A/B), confirming discordant cases by isothermal amplification. Demographic variables, comorbidities, type of acquisition, previous administration of antibiotics, antacids and immunosuppressants, and evolution were collected. The data were analysed using the chi-square test and the effect of risk and prognostic factors was quantified using an odds ratio with 95% confidence intervals. Hospital admission 4 weeks prior to infection, hypoalbuminemia, and previous administration of antibiotics were identified as independent risk factors for CDI. Presenting these 3 factors constitutes nearly 3-fold increase in the risk of becoming infected. A greater number of hospital admissions in the 4-12 weeks prior to CDI were found in the group of nosocomial acquisition. Although there was a greater tendency to recurrence and an unfavourable prognosis among nosocomial cases, these differences were not significant. We found that fever and hospital admission in the 4 weeks prior to infection were unfavourable prognostic factors of CDI. The independent risk factors for CDI were: Hospital admission in the 4 weeks prior to infection, hypoalbuminemia, and previous administration of antibiotics. Fever and hospitalisation in the previous 4 weeks were also identified as prognostic factors of unfavourable evolution. Copyright © 2022. Publicado por Elsevier España, S.L.U.

Citation

Cristina Muñoz Cuevas, María Ángeles Asencio Egea, María Franco Huerta, María Huertas Vaquero, Ángel Arias Arias, Rafael Carranza González. Case-control study of Clostridioides difficile in a rural health care area. Gastroenterologia y hepatologia. 2023 Jan;46(1):1-9