Risk Factors for Clostridium difficile-Associated Diarrhea

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  • HATTORI Mariko
    Department of Clinical Laboratory, Tokyo Rosai Hospital Infection Control Team, Tokyo Rosai Hospital
  • SAKAMOTO Takuya
    Department of Pharmacy, Tokyo Rosai Hospital Infection Control Team, Tokyo Rosai Hospital
  • KAWAI Yoshitomo
    Department of Pharmacy, Tokyo Rosai Hospital
  • MATSUDA Toshiyuki
    Department of Pharmacy, Tokyo Rosai Hospital Infection Control Team, Tokyo Rosai Hospital
  • KUMAZAWA Mikiko
    Department of Nursing, Tokyo Rosai Hospital Infection Control Team, Tokyo Rosai Hospital
  • ENDO Yoko
    Department of Nursing, Tokyo Rosai Hospital Infection Control Team, Tokyo Rosai Hospital
  • TOJIMA Hirokazu
    Department of Respiratory Medicine, Tokyo Rosai Hospital Infection Control Team, Tokyo Rosai Hospital

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Other Title
  • Ｃｌｏｓｔｒｉｄｉｕｍ　ｄｉｆｆｉｃｉｌｅ関連下痢症患者における危険因子の検討
  • Clostridium difficile カンレン ゲリショウ カンジャ ニ オケル キケン インシ ノ ケントウ

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Clostridium difficile is the most common cause of antimicrobial-associated diarrhea. Several studies have evaluated risk factors for C. difficile-associated diarrhea (CDAD), but most have selected patients without diarrhea as the control group. Nosocomial diarrhea has various causes, so the clinical characteristics of hospitalized patients who developed CDAD were compared with those of patients hospitalized in the same period who had CD negative diarrhea. Case patients were defined as patients who had diarrhea and tested positive for CDtoxin A or B by enzyme immunoassay (Nissui TOX A/B QUIK CHEK). Control patients were inpatients who had diarrhea and tested negative for CDtoxin A or B. A total of 33 case patients and 108 control patients were identified. Case patients and control patients had similar mean age, length of stay, and history of antimicrobial agent use. Univariate analysis showed patients with CDAD were more likely to be male, positive for MRSA, and to have hypoalbuminemia (lower than 3.0 g/dL). Logistic regression analysis revealed only hypoalbuminemia (odds ratio; 14.8, 95%CI; 3.36 to 64.8, p<0.001) as a risk factor for CDAD. Case patients and control patients had many common risk factors in this study, so a significant difference was identified only for hypoalbuminemia. Patients with hypoalbuminemia receiving antimicrobial agents may represent a high risk group for CDAD.<br>

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