Risk factors for Clostridium difficile infection in hospitalized patients with community-acquired pneumonia

James D. Chalmers (Lead / Corresponding author), Ahsan R. Akram, Aran Singanayagam, Mark H. Wilcox, Adam T. Hill

    Research output: Contribution to journalArticlepeer-review

    56 Citations (Scopus)
    270 Downloads (Pure)

    Abstract

    ObjectivesClostridium difficile infection (CDI) is strongly associated with anti-biotic treatment, and community-acquired pneumonia (CAP) is the leading indication for anti-biotic 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 analysis. 

    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.

    Original languageEnglish
    Pages (from-to)45-53
    Number of pages9
    JournalJournal of Infection
    Volume73
    Issue number1
    Early online date19 Apr 2016
    DOIs
    Publication statusPublished - Jul 2016

    Keywords

    • Antibiotics
    • Clostridium difficile
    • Healthcare-associated infections
    • Macrolides
    • Pneumonia

    ASJC Scopus subject areas

    • Microbiology (medical)
    • Infectious Diseases

    Fingerprint

    Dive into the research topics of 'Risk factors for Clostridium difficile infection in hospitalized patients with community-acquired pneumonia'. Together they form a unique fingerprint.

    Cite this