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Volume 16, Number 2—February 2010

CME ACTIVITY

Risk Factors for and Estimated Incidence of Community-associated Clostridium difficile Infection, North Carolina, USA1

Preeta K. Kutty, Christopher W. Woods, Arlene C. Sena, Stephen R. Benoit, Susanna Naggie, Joyce Frederick, Sharon Evans, Jeffery Engel, and L. Clifford McDonaldComments to Author 
Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (P.K. Kutty, S.R. Benoit, L.C. McDonald); Department of Veterans Affairs Medical Center, Durham, North Carolina, USA (C.W. Woods, S. Naggie, J. Frederick); Duke University Medical Center, Durham (C.W. Woods, S. Naggie, S. Evans); Durham County Health Department, Durham (A.C. Sena); University of North Carolina, Chapel Hill, North Carolina, USA (A.C. Sena); North Carolina Department of Health and Human Services, Raleigh, North Carolina, USA (J. Engel); 1Presented in part at the 44th Annual Meeting of the Infectious Diseases Society of America, Toronto, Ontario, Canada, October 12–15, 2006.

Main Article

Table 2

Results of community-associated Clostridium difficile infection case–control study, Veterans Affairs, North Carolina, USA, 2005*

Characteristic No. (%) persons
OR (95% CI)
Case-patients, n = 36 Controls, n = 108
Demographics
Median age, y (range) 62 (38–85) 64 (36–86)
Female gender 4 (11) 4 (4)
Non-Hispanic white race
25 (69)
70 (65)

Coexisting health conditions
Hypertension 16 (44) 75 (69) 0.35 (0.2–0.8)†
Cardiac failure
6 (17)
5 (5)
4.1 (1.2–14.4)†
Exposures‡
Outpatient visit 32 (89) 69 (57) 6.1 (2.0–18.6)†
Antimicrobial drugs 24 (66) 10 (9) 19.6 (7.6–51.0)†
Penicillins 13 (36) 3 (3) 19.8 (5.2–75.1)§
Quinolones 6 (17) 3 (3) 7 (1.7–29.7)†
NSAIDs 6 (17) 30 (28) 0.5 (0.2–0.4)
Antimotility medications 4 (11) 2 (2) 6.6 (1.2–37.8)†
Gastric acid suppressors 18 (50) 37 (34) 1.9 (0.9–4.1)
H2 blockers 7 (19) 13 (12) 1.8 (0.6–4.8)
Proton pump inhibitors 13 (36) 26 (24) 1.7 (0.7–4.0)
Steroids
4 (11)
3 (3)
4.4 (0.9–20.5)
Multivariable analysis¶
Antimicrobial drugs 17.8 (6.6–48.0)#
Outpatient visit 5.1 (1.5–17.9)†#

*OR, odds ratio; CI, confidence interval; NSAIDs, nonsteroidal antiinflammatory drugs.
†p<0.05.
‡Exposures among case-patients and controls were within 3 months prior to the test date.
§p< 0.0001.
¶Goodness-of-fit tests: residual χ2, p = 0.33; Hosmer and Lemeshow, p = 0.12.
#Adjusted OR.

Main Article

1Presented in part at the 44th Annual Meeting of the Infectious Diseases Society of America, Toronto, Ontario, Canada, October 12–15, 2006.

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