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| Risk factors for Clostridium difficile infection in cirrhotic patients |
| Dong Yan a , Yan-Di Huang b , Yun-Bo Chen a , Tao Lv a , Si-Lan Gu a , Yong-Tao Li a , Jian-Rong Huang a , Lan-Juan Li a , ∗ |
a State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
b Department of Laboratory Medicine, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
∗ Corresponding author.
E-mail address: ljli@zju.edu.cn (L.-J. Li). |
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Abstract Background: Cirrhotic patients are susceptible to Clostridium difficile infection (CDI), however, the high risk factors are not clear. The present study aimed to identify the risk factors in cirrhotic patients with CDI.
Methods: A total of 526 cirrhotic patients admitted to our hospital between May 2015 and October 2015 were included in this study. Stool samples were collected upon admission for the detection of CDI and toxin. CDI was monitored during the hospital stay. In total, 34 cases showed CDI. Then we analyzed the effects of age, sex, C. difficile colonization (CDC), multiple hospitalization, extended hospital stay, elevation of total bilirubin (TBIL), creatinine (Cr), Child-Pugh grade C, hepatic encephalopathy, hepatorenal syn- drome, upper gastrointestinal hemorrhage, and exposure of antibiotics and proton pump inhibitor (PPI) on the CDI in cirrhotic patients.
Results: Patients in the CDI group had more frequent CDC, multiple hospitalization, and extended hospital stay compared to those in the non- C. difficile infection (NCDI) group. Patients in the CDI group had higher TBIL and Cr, and higher frequency of Child-Pugh grade C, hepatic encephalopathy, upper gastrointestinal hemorrhage compared with those in the NCDI group. Multiple logistic regression analysis indicated that age > 60 years (OR = 1.689; 95% CI: 1.135–3.128), multiple hospitalization (OR = 3.346; 95% CI: 1.392–8.043), length of hospital stay > 20 days (OR = 1.564; 95% CI: 1.113–2.563), hypoproteinemia (OR = 4.962; 95% CI: 2.053–11.996), CDC (OR = 18.410; 95% CI: 6.898–49.136), hepatic encephalopathy (OR = 1.357; 95% CI: 1.154–2.368), and exposure of antibiotics (OR = 1.865; 95% CI: 1.213–2.863) and PPI (OR = 3.125; 95% CI: 1.818–7.548) were risk factors of CDI.
Conclusions: Age > 60 years, multiple hospitalization, length of hospital stay > 20 days, hypoproteinemia, CDC, hepatic encephalopathy, and exposure of antibiotics and PPI were risk factors for CDI in cirrhotic patients. These may contribute to the early diagnosis and monitoring of CDI in clinical practice.
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2019, Vol. 18 
