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Influence of cohorting patients with Clostridium difficile infection on risk of symptomatic recurrence
journal contribution
posted on 2023-06-08, 18:18 authored by J Islam, E Cheek, V Navani, C Rajkumar, J Cohen, Martin LlewelynMartin LlewelynBACKGROUND Cohorting of patients with Clostridium difficile infection (CDI) is recommended when single side-rooms are unavailable. Although patients may remain infectious after cessation of diarrhoea, continued cohorting may place them at increased risk of reinfection. AIM To identify risk factors for CDI recurrence and to determine whether cohorting of patients is associated with increased risk of recurrence. METHODS Data describing patient demographics, comorbidity, CDI severity and treatment were collected for 248 CDI patients at our hospital between October 2008 and June 2011. The primary outcome was symptomatic recurrence within 30 days of diagnosis. FINDINGS One hundred and thirty-eight (55.6%) CDI patients were admitted to the cohort ward. These patients were more likely to have severe CDI (odds ratio: 1.95; 95% confidence interval: 1.10-3.46; P = 0.022) and receive vancomycin (1.59; 0.94-2.68; P = 0.083) than patients who were not cohorted. Twenty-six patients (10.5%) suffered recurrence (21 cohorted and five not cohorted). Urinary infection on admission (5.16; 2.10-12.64; P < 0.001), cohorting (3.77; 1.37-10.35; P = 0.01) and concomitant antibiotics (2.07; 0.91-4.72; P = 0.083) were associated with increased risk of recurrence. On multivariate analysis, cohorting (3.94; 1.23-12.65; P = 0.021) and urinary infection (4.27; 1.62-11.24; P = 0.003) were significant predictors of recurrence. CONCLUSION Patients admitted to a C. difficile cohort ward may be at increased risk of recurrence because they are at increased risk of reinfection. Hospitals using cohort wards to control C. difficile should manage patient flow through the cohort to minimize this risk.
History
Publication status
- Published
Journal
Journal of Hospital InfectionISSN
0195-6701Publisher
ElsevierExternal DOI
Issue
1Volume
85Page range
17-21Department affiliated with
- Global Health and Infection Publications
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- No
Peer reviewed?
- Yes
Legacy Posted Date
2014-09-15Usage metrics
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