Drug risk factors associated with a sustained outbreak of Clostridium difficile diarrhea in a teaching hospital.

The Canadian Journal of Infectious Diseases = Journal Canadien Des Maladies Infectieuses
S K NathC Rotstein

Abstract

A case-control study was undertaken to identify and quantify antimicrobial and nonantimicrobial drug risk factors associated with a sustained outbreak of Clostridium difficile diarrhea on two medical (teaching and nonteaching) units and an oncology unit. In total, 80 cases associated with an endemic clone of toxigenic C difficile were compared with controls. Eighty controls were selected from a group of 290 controls randomly chosen from the outbreak period. The controls were matched to cases according to age, admitting diagnosis and unit of admission. Seventy (88%) patients in the case group received at least one antibiotic before diarrhea, compared with 37 (46%) patients in the control group. Major risk factors implicated in the development of C difficile diarrhea in hospitalized patients were the following antimicrobial agents: ceftazidime (adjusted odds ratio [aor]=26.01, 95% ci 5.67 to 119.19, P=0.0001); cefuroxime (aor=5.17, ci 1.86 to 14.36, P=0.005); ciprofloxacin (aor=3.81, ci 1.05 to 13.79, P=0.04); and clindamycin (aor=15.16, ci 2.93 to 78.44, P=0.004). This is the first time that the use of ciprofloxacin has been linked to the development of C difficile diarrhea. Use of gastrointestinal drugs (ranitidine, famotidine,...Continue Reading

Citations

May 11, 2016·Critical Care Medicine·Jeffrey F BarlettaDeborah J Cook
Nov 28, 2002·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Claudia ThomasThomas V Riley
Sep 21, 2017·Neurocritical Care·Jeffrey F BarlettaVictor Zach
May 19, 2007·The American Journal of Gastroenterology·Jennifer LeonardPaul Moayyedi

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