Asymptomatic Clostridium difficile colonization in a tertiary care hospital: Admission prevalence and risk factors

Surbhi Leekha, Kimberly C. Aronhalt, Lynne M. Sloan, Robin Patel, Robert Orenstein

Research output: Contribution to journalArticle

69 Scopus citations

Abstract

Background: The role of Clostridium difficile (CD) carriers in health care-associated CD transmission has been identified as an area needing research. We investigated the prevalence of, and risk factors for, asymptomatic CD colonization at hospital admission. Methods: Adults admitted to a tertiary care hospital in Minnesota on predetermined study days between March 1 and April 30, 2009, and without symptoms of C difficile infection, were eligible. The first stool sample after admission was requested from each consenting patient and tested for toxigenic CD using polymerase chain reaction (PCR) that detects tcdC. Clinical data were obtained through interviews and chart reviews. Results: Of 320 participants, 31 (9.7%) were positive for toxigenic CD. Using multivariate logistic regression, independent predictors of CD colonization were recent hospitalization (odds ratio [OR], 2.45; 95% confidence interval [CI]: 1.02-5.84), chronic dialysis (OR, 8.12; 95% CI: 1.80-36.65), and corticosteroid use (OR, 3.09; 95% CI: 1.24-7.73). Screening patients with risk factors (48% participants) would identify 74% (95% CI: 55%-88%) of CD carriers. Conclusion: Asymptomatic CD colonization at hospital admission was detected in nearly 1 of 10 patients. The majority of colonized patients had one or more identifiable risk factors. These data could provide the basis for designing studies of targeted surveillance for C difficile.

Original languageEnglish (US)
Pages (from-to)390-393
Number of pages4
JournalAmerican journal of infection control
Volume41
Issue number5
DOIs
StatePublished - May 1 2013

Keywords

  • Healthcare epidemiology
  • PCR
  • Surveillance
  • Targeted screening

ASJC Scopus subject areas

  • Epidemiology
  • Health Policy
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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