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Risk Factors for and Estimated Incidence of Community-associated Clostridium difficile Infection, North Carolina, USA 1

2010; Centers for Disease Control and Prevention; Volume: 16; Issue: 2 Linguagem: Inglês

10.3201/eid1602.090953

1080-6059

Preeta K. Kutty, Christopher W. Woods, Arlene C. Seña, Stephen R. Benoit, Susanna Naggie, Joyce Frederick, Sharon Evans, Jeffery Engel, L. Clifford McDonald,

Nosocomial Infections in ICU

We determined estimated incidence of and risk factors for community-associated Clostridium difficile infection (CA-CDI) among patients treated at 6 North Carolina hospitals. CA-CDI case-patients were defined as adults (>18 years of age) with a positive stool test result for C. difficile toxin and no hospitalization within the prior 8 weeks. CA-CDI incidence was 21 and 46 per 100,000 person-years in Veterans Affairs (VA) outpatients and Durham County populations, respectively. VA case-patients were more likely than controls to have received antimicrobial drugs (adjusted odds ratio [aOR] 17.8, 95% confidence interval [CI] 6.6-48] and to have had a recent outpatient visit (aOR 5.1, 95% CI 1.5-17.9). County case-patients were more likely than controls to have received antimicrobial drugs (aOR 9.1, 95% CI 2.9-28.9), to have gastroesophageal reflux disease (aOR 11.2, 95% CI 1.9-64.2), and to have cardiac failure (aOR 3.8, 95% CI 1.1-13.7). Risk factors for CA-CDI overlap with those for healthcare-associated infection.