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Asymptomatic Clostridium difficile colonization in a tertiary care hospital: Admission prevalence and risk factors.
MedLine Citation:
PMID:  23622704     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
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.
Authors:
Surbhi Leekha; Kimberly C Aronhalt; Lynne M Sloan; Robin Patel; Robert Orenstein
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of infection control     Volume:  41     ISSN:  1527-3296     ISO Abbreviation:  Am J Infect Control     Publication Date:  2013 May 
Date Detail:
Created Date:  2013-04-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8004854     Medline TA:  Am J Infect Control     Country:  United States    
Other Details:
Languages:  eng     Pagination:  390-3     Citation Subset:  IM    
Copyright Information:
Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.
Affiliation:
Division of Infectious Diseases, Mayo Clinic, Rochester, MN. Electronic address: sleekha@epi.umaryland.edu.
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