Abstract
Clostridium difficile is the most common cause of antimicrobial-associated diarrhea. Several studies have evaluated risk factors for C. difficile-associated diarrhea (CDAD), but most have selected patients without diarrhea as the control group. Nosocomial diarrhea has various causes, so the clinical characteristics of hospitalized patients who developed CDAD were compared with those of patients hospitalized in the same period who had CD negative diarrhea. Case patients were defined as patients who had diarrhea and tested positive for CDtoxin A or B by enzyme immunoassay (Nissui TOX A/B QUIK CHEK). Control patients were inpatients who had diarrhea and tested negative for CDtoxin A or B. A total of 33 case patients and 108 control patients were identified. Case patients and control patients had similar mean age, length of stay, and history of antimicrobial agent use. Univariate analysis showed patients with CDAD were more likely to be male, positive for MRSA, and to have hypoalbuminemia (lower than 3.0 g/dL). Logistic regression analysis revealed only hypoalbuminemia (odds ratio; 14.8, 95%CI; 3.36 to 64.8, p<0.001) as a risk factor for CDAD. Case patients and control patients had many common risk factors in this study, so a significant difference was identified only for hypoalbuminemia. Patients with hypoalbuminemia receiving antimicrobial agents may represent a high risk group for CDAD.
