Risk factors for Clostridium difficile infection in hospitalized patients with community-acquired pneumonia.
J Infect. 2016 Apr 19;
Authors: Chalmers JD, Akram AR, Singanayagam A, Wilcox MH, Hill AT
OBJECTIVES: Clostridium difficile infection (CDI) is strongly associated with antibiotic treatment, and community-acquired pneumonia (CAP) is the leading indication for antibiotic prescription in hospitals. This study assessed the incidence of and risk factors for CDI in a cohort of patients hospitalized with CAP.
METHODS: We analysed data from a prospective, observational cohort of patients with CAP in Edinburgh, UK. Patients with diarrhoea were systematically screened for CDI, and risk factors were determined through time-dependent survival anaylsis.
RESULTS: Overall, 1883 patients with CAP were included, 365 developed diarrhoea and 61 had laboratory-confirmed CDI. The risk factors for CDI were: age (hazard ratio [HR], 1.06 per year; 95% confidence interval [CI] 1.03-1.08), total number of antibiotic classes received (HR, 3.01 per class; 95% CI 2.32-3.91), duration of antibiotic therapy (HR, 1.09 per day; 95% CI, 1.00-1.19 and hospitalization status (HR 13.1 95% CI 6.0-28.7). Antibiotic class was not an independent predictor of CDI when adjusted for these risk factors (p > 0.05 by interaction testing).
CONCLUSIONS: These data suggest that reducing the overall antibiotic burden, duration of antibiotic treatment and duration of hospital stay may reduce the incidence of CDI in patients with CAP.
PMID: 27105657 [PubMed - as supplied by publisher]