• Medicina clinica · Oct 2019

    Factors associated to Clostridium difficile infection in a hospital-based home care service.

    • Stefanie Francesca Pini, Giusi Alessia Sgaramella, Juan José Parra Jordán, Ana Aguilera Zubizarreta, Emilio Pariente Rodrigo, and Pedro Sanroma Mendizabal.
    • Servicio de Hospitalización Domiciliaria, Hospital Universitario Marqués de Valdecilla, Santander, España. Electronic address: p.stefanie87@gmail.com.
    • Med Clin (Barc). 2019 Oct 25; 153 (8): 319-322.

    Background And ObjectiveThere are no data related to the risk factors associated with CDI in a Hospital-Based Home Care Service (HBHCS) of the Spanish health system.Patients And MethodsCase-control study. The cases were patients admitted to the HBHCS between 01/01/2011 and 31/12/2016 who developed CDI. The controls came from the same population, with suspected CDI and CD(-) toxin. We analysed 82 variables.ResultsWe analysed 17 cases and 95 controls, without differences in sex, age or comorbidity. Diarrhoea was noted in 94% and 92%, and a percentage of deaths of 18% and 1%, respectively (P=.001). The presence of hemiplegia/paraplegia (adjusted odds ratio [OR]=26.4, 95% CI 2.9-235.6, P=.003) showed a significant relationship with CDI, while chronic respiratory disease and the use of cephalosporins did so with marginal significance (adjusted OR=2.9, 95% CI 0.8-10.3 and 3.1, 95% CI 0.8-11.3, respectively, both P=.08).ConclusionsActions in the HBHCS directed towards CDI should include a reduction in the use of high-risk antibiotics -according to our results, cephalosporins- especially in patients with specific comorbidities, such as hemiplegia/tetraplegia or a chronic respiratory disease.Copyright © 2018 Elsevier España, S.L.U. All rights reserved.

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