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Quinolone Use as a Risk Factor for Nosocomial Clostridium difficile-Associated Diarrhea

Published online by Cambridge University Press:  02 January 2015

Clarwyn Yip ,
Mark Loeb ,
Suzette Salama ,
Lorraine Moss  and
Jan Olde
Clarwyn Yip
Affiliation:
Department of Medicine, McMaster University, Hamilton, Ontario, Canada
Mark Loeb*
Affiliation:
Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada Hamilton Civics Hospital, Hamilton, Ontario, Canada
Suzette Salama
Affiliation:
Department of Medicine, McMaster University, Hamilton, Ontario, Canada
Lorraine Moss
Affiliation:
Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
Jan Olde
Affiliation:
Hamilton Civics Hospital, Hamilton, Ontario, Canada
*
Hamilton Health Sciences Corporation, 711 Concession St, Hamilton, Ontario L8V1C3, Canada
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Abstract

Objective:

To determine modifiable risk factors for nosocomial Clostridium difficile-associated diarrhea (CDAD).

Design:

Case-control study.

Setting:

300-bed tertiary-care hospital.

Participants:

Hospital inpatients present during the 3-month study period.

Methods:

Case-patients identified with nosocomial CDAD over the study period were compared to two sets of control patients: inpatients matched by age, gender, and date of admission; and inpatients matched by duration of hospital stay. Variables including demographic data, comorbid illnesses, antibiotic exposure, and use of gastrointestinal medications were assessed for case- and control-patients. Conditional logistic regression was performed to identify risk factors for nosocomial CDAD.

Results:

27 case-patients were identified and were compared to the two sets of controls (1:1 match for each comparison set). For the first set of controls, use of ciprofloxacin (odds ratio [OR], 5.5; 95% confidence interval [CI95], 1.2-24.8; P=.03) was the only variable that remained significant in the multivariable model. For the second set of controls, prior exposure to cephalosporins (OR, 6.7; CL,5, 1.3-33.7; P=.02) and to ciprofloxacin (OR, 9.5; CI95, 1.01-88.4; P=.05) were kept in the final model.

Conclusions:

Along with cephalosporins, prior quinolone use predisposed hospitalized patients to nosocomial CDAD. Quinolones should be used judiciously in acute-care hospitals, particularly in those where CDAD is endemic.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 22 , Issue 9 , September 2001 , pp. 572 - 575
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2001

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