Factors associated with Clostridium difficile diarrhea in a hospital in Beijing,China

Clostridium difficile is the most common cause of hospital-acquireddiarrhea in patients treated with antibiotics, chemotherapeutic agents, and otherdrugs that alter the normal equilibrium of the intestinal flora. A betterunderstanding of the risk factors for C. difficile-associateddisease (CDAD) could be used to reduce the incidence of CDAD and the costs associatedwith its treatment. The aim of this study was to identify the risk factors for CDADin a cohort of Chinese patients in a Beijing hospital. Medical charts of a total of130 inpatients (62 males and 68 females) with hospital-acquired diarrhea (45 withCDAD; 85 without CDAD) were retrospectively reviewed. C. difficiletoxins A and B were detected in fecal samples using enzyme-linked fluorescenceassays. The drugs used by patients with and without CDAD before the onset of diarrheawere compared. Factors that differed significantly between the two groups byunivariate analysis were analyzed by multivariate analysis using a logisticregression model. Multivariate analysis showed that cephalosporin treatment wasassociated with a significantly higher risk of CDAD in hospitalized patients, whiletreatment with glycopeptides was significantly associated with a reduction in CDAD(P<0.001 for cephalosporin; P=0.013 for glycopeptides). Our data confirmedprevious findings that empirical treatment with cephalosporins is positivelyassociated with CDAD compared to individuals using other CDAD-related drugs.Additionally, we showed that treatment with glycopeptides was negatively associatedwith CDAD, compared to individuals using other CDAD-related drugs.