Risk factors associated with Clostridium difficile diarrhea in hospitalized adult patients: a case-control study–sucralfate ingestion is not a negative risk factor.

Risk factors associated with Clostridium difficile diarrhea in hospitalized adult patients: a case-control study–sucralfate ingestion is not a negative risk factor.

Watanakunakorn P W; Watanakunakorn C; Hazy J

Infection control and hospital epidemiology

1996

1996-04

OBJECTIVES: To assess risk factors associated with Clostridium difficile diarrhea in hospitalized adult patients, and to test the hypothesis that sucralfate ingestion is associated with nondetection of C difficile cytotoxin in stool specimens. DESIGN: A retrospective case-control study of hospitalized adult patients who had stool specimens assayed for C difficile cytotoxin. For each patient who had positive C difficile cytotoxin, a patient who had negative C difficile cytotoxin was used as a control. The study period was January to December 1993. SETTING: A community teaching hospital affiliated with a medical school in northeastern Ohio. RESULTS: There were 91 case patients and 91 control patients. Cephalosporin exposure was identified as a risk factor in patients with C difficile diarrhea. The number of patients who had sucralfate ingestion was comparable in both groups of patients. CONCLUSIONS: Administration of cephalosporins was identified as a risk factor in patients with C difficile diarrhea. We were not able to confirm a recent report of the association between ingestion of sucralfate and nondetection of C difficile cytotoxin in stool specimens. Our findings suggest that sucralfate ingestion is not associated with nondetection of C difficile cytotoxin in stool specimens. Assay of C difficile cytotoxin in stool specimens remains a valid method of diagnosing C difficile diarrhea, even in patients who ingest sucralfate.

Adult; Female; Humans; Male; Middle Aged; Ohio; Adolescent; Aged; Hospitalization; Case-Control Studies; Feces/microbiology; *Clostridium difficile; Diarrhea/*epidemiology/microbiology; Sucralfate/*administration & dosage; 80 and over; Enterocolitis; Pseudomembranous/*epidemiology/microbiology

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232–235

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