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Risk Factors for Clostridium difficile Carriage and C. difficile-Associated Diarrhea in a Cohort of Hospitalized Patients
Abstract
A prospective cohort study of 399 consecutive patients in a single ward over an 11-month period was conducted to identify risk factors for nosocomial C. difficile colonization and diarrhea. The incidence of asymptomatic carriage was 13.0/100 patient admissions and the incidence of C. difficile-associated diarrhea was 7.8/100 patient admissions. Increased age and more severe underlying illness were associated with increased risk of C. difficile carriage and diarrhea. Multivariate models adjusting for age and severity of underlying disease associated two risk factors with asymptomatic C. difficile carriage: stool softeners (relative risk [RR] = 2.04) and antacids (RR = 1.80). Five risk factors were associated with C. difficile-associated diarrhea: cephalosporin use (RR = 2.07), penicillin use (RR = 3.41), enemas (RR = 3.26), gastrointestinal stimulants (RR = 3.06), and stool softeners (RR = 1.74). C. difficile was a common nosocomial infection on this ward, resulting in asymptomatic carriage more often than diarrhea and accounting for one-fifth of all cases of nosocomial diarrhea.
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Cited by
Guidelines for diagnosis, treatment, and prevention of Clostridium difficile infections
Surawicz, C. M., Brandt, L. J., Binion, D. G., Ananthakrishnan, A. N., Curry, S. R., Gilligan, P. H., McFarland, L. V., Mellow, M., & Zuckerbraun, B. S. (2013) · American Journal of Gastroenterology · doi:10.1038/ajg.2013.4 · Cited by 1,645
Emergence of Clostridium difficile-associated disease in North America and Europe
Kuijper, E. J., Coignard, B., & Tüll, P. (2006) · Clinical Microbiology and Infection · doi:10.1111/j.1469-0691.2006.01580.x · Cited by 855
Diagnosis and Treatment of Clostridium difficile in Adults: A Systematic Review
Bagdasarian, N., Rao, K., & Malani, P. N. (2015) · JAMA · doi:10.1001/jama.2014.17103 · Cited by 451
Wistrom, J. (2001) · Journal of Antimicrobial Chemotherapy · doi:10.1093/jac/47.1.43 · Cited by 448
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Metadata
- Authors
- McFarland, L. V., Surawicz, C. M., & Stamm, W. E.
- Venue
- Journal of Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 1990-09-01
- Volume
- 162
- Issue
- 3
- Pages
- 678-684
- ISSN
- 0022-1899 (ISSN-L)
- 1537-6613
- OpenAlex
- W2078225590
- Cited by
- 378
- References
- 0
- FWCI
- 5.68
- Type
- journal article
- Language
- en
- Open access
- closed
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- CoChat. (2026). Citation check: Risk Factors for Clostridium difficile Carriage and C. difficile-Associated Diarrhea in a Cohort of Hospitalized Patients. https://app.cochat.ai/papers/10.1093/infdis/162.3.678
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- McFarland, L. V., Surawicz, C. M., & Stamm, W. E. (1990). Risk Factors for Clostridium difficile Carriage and C. difficile-Associated Diarrhea in a Cohort of Hospitalized Patients. Journal of Infectious Diseases. https://doi.org/10.1093/infdis/162.3.678
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.
