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Toxigenic Clostridium difficile colonization among hospitalised adults; risk factors and impact on survival
journal contribution
posted on 2023-06-09, 06:14 authored by Laura Behar, David Chadwick, Angela Dunne, Chris JonesChris Jones, Clare Procter, Chakravarthi RajkumarChakravarthi Rajkumar, Paula Sharratt, Philip Stanley, Angela Whiley, Mark Wilks, Martin LlewelynMartin LlewelynObjectives: To establish risk factors for Clostridium difficile colonization among hospitalized patients in England. Methods: Patients admitted to elderly medicine wards at three acute hospitals in England were recruited to a prospective observational study. Participants were asked to provide a stool sample as soon as possible after enrolment and then weekly during their hospital stay. Samples were cultured for C. difficile before ribotyping and toxin detection by PCR. A multivariable logistic regression model of risk factors for C. difficile colonization was fitted from univariable risk factors significant at the p < 0.05 level. Results: 410/727 participants submitted =1 stool sample and 40 (9.8%) carried toxigenic C. difficile in the first sample taken. Ribotype 106 was identified three times and seven other ribotypes twice. No ribotype 027 strains were identified. Independent predictors of colonization were previous C. difficile infection (OR 4.53 (95% C.I. 1.33–15.48) and malnutrition (MUST score =2) (OR 3.29 (95% C.I. 1.47–7.35)). Although C. difficile colonised patients experienced higher 90-day mortality, colonization was not an independent risk for death. Conclusions: In a non-epidemic setting patients who have previously had CDI and have a MUST score of =2 are at increased risk of C. difficile colonization and could be targeted for active surveillance to prevent C. difficile transmission.
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Publication status
- Published
File Version
- Published version
Journal
Journal of InfectionISSN
0163-4453Publisher
ElsevierExternal DOI
Issue
1Volume
75Page range
20-25Department affiliated with
- Clinical and Experimental Medicine Publications
Full text available
- Yes
Peer reviewed?
- Yes
Legacy Posted Date
2017-05-10First Open Access (FOA) Date
2017-05-30First Compliant Deposit (FCD) Date
2017-05-10Usage metrics
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