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Volume 27, Number 12—December 2021
CME ACTIVITY - Research

Trends in Incidence and Clinical Outcomes of Clostridioides difficile Infection, Hong Kong

Cosmos L.T. Guo1, Thomas N.Y. Kwong1, Joyce W.Y. Mak, Lin Zhang, Grace C.Y. Lui, Grace L.H. Wong, Margaret Ip, Jun Yu, Joseph J.Y. Sung, William K.K. Wu2, and Sunny H. Wong2Comments to Author 
Author affiliations: The Chinese University of Hong Kong, Hong Kong, China (C.L.T. Guo, T.N.Y. Kwong, J.W.Y. Mak, L. Zhang, G.C.Y. Lui, G.L.H. Wong, M. Ip, J. Yu, J.J.Y. Sung, W.K.K. Wu, S.H. Wong); Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore (J.J.Y. Sung, S.H. Wong)

Main Article

Table 3

Logistic regression analysis of potential independent variables associated with 30-day mortality for Clostridioides difficile infection, Hong Kong, China, 2015–2019*

Variable Univariate
 Multivariate
OR (95% CI) p value OR (95% CI) p value
Age, y
<44 Referent NA Referent NA
45–64 3.115 (2.301–4.322) <0.001 2.458 (1.794–3.449) <0.001
65–74 4.203 (3.105–5.829) <0.001 3.203 (2.334–4.502) <0.001
75–84 6.237 (4.643–8.595) <0.001 5.384 (3.944–7.531) <0.001
>85
 7.986 (5.959–10.986)
 <0.001
7.633 (5.583–10.70)
 <0.001
Male sex
 1.124 (1.041–1.213)
 0.0029
1.221 (1.121–1.330)
 <0.001
IDSA-defined severe disease
 2.296 (2.121–2.486)
 <0.001
2.159 (1.986–2.347)
 <0.001
Healthcare-associated disease
 2.483 (2.066–3.010)
 <0.001
1.378 (1.119–1.708)
 0.003
Admission from OAH 1.716 (1.579–1.864) <0.001 1.327 (1.203–1.463) <0.001
Diagnostic test
Bacterial culture Referent NA Referent NA
Nucleic acid amplification test 1.070 (0.991–1.157) 0.0845 1.046 (0.962–1.138) 0.294
Toxin detection
 0.995 (0.669–1.438)
 0.9799
0.904 (0.592–1.343)
 0.629
Antimicrobial drug use
High-risk drugs 2.243 (1.990–2.534) <0.001 0.753 (0.603–0.939) 0.012
Medium-risk drugs 1.021 (0.893–1.164) 0.7602 1.988 (0.653–8.670) 0.281
Low-risk drugs 1.193 (1.094–1.300) 0.0001 0.841 (0.647–1.092) 0.193
Broad-spectrum drugs 1.673 (1.542–1.817) <0.001 1.402 (1.244–1.581) <0.001
Aminoglycosides 0.907 (0.773–1.059) 0.2223 1.026 (0.825–1.272) 0.815
Beta-lactamase inhibitor 2.276 (2.063–2.516) <0.001 1.465 (1.047–2.052) 0.026
Carbapenem 1.229 (1.118–1.349) <0.001 1.233 (0.967–1.571) 0.091
Cephalosporin 1.180 (1.087–1.279) 0.0001 0.936 (0.848–1.033) 0.187
Lincosamides 0.901 (0.554–1.400) 0.6580 1.126 (0.674–1.800) 0.634
Macrolides 1.411 (1.201–1.650) <0.001 0.604 (0.140–1.812) 0.425
Penicillin 2.208 (2.003–2.438) <0.001 1.165 (0.840–1.624) 0.362
Quinolones 1.115 (1.020–1.218) 0.0161 0.939 (0.843–1.045) 0.251
Sulphonamides 0.588 (0.465–0.734) <0.001 0.395 (0.092–1.167) 0.138
Tetracyclines
 1.291 (1.081–1.534)
 0.0043
1.219 (0.955–1.548)
 0.108
Use of other drugs
Proton pump inhibitor 1.614 (1.486–1.755) <0.001 1.182 (1.073–1.304) <0.001
H2 antagonist 1.237 (1.136–1.346) <0.001 1.225 (1.109–1.353) <0.001
Corticosteroid
 0.954 (0.876–1.038)
 0.2759
0.919 (0.835–1.010)
 0.080
Underlying conditions
Myocardial infarction 1.268 (1.100–1.457) 0.0009 1.022 (0.871–1.195) 0.791
Congestive heart failure 1.632 (1.475–1.804) <0.001 1.358 (1.208–1.525) <0.001
Peripheral vascular disease 1.218 (0.989–1.489) 0.0588 0.980 (0.781–1.221) 0.859
Cerebrovascular disease 1.204 (1.092–1.325) 0.0002 1.021 (0.911–1.143) 0.722
Nonmetastatic cancer 1.498 (1.368–1.638) <0.001 1.657 (1.468–1.869) <0.001
Metastatic cancer 2.827 (2.466–3.237) <0.001 2.627 (2.209–3.124) <0.001
Diabetes mellitus 1.267 (1.157–1.386) <0.001 1.052 (0.948–1.168) 0.339
Diabetes mellitus with complications 1.226 (1.076–1.394) 0.0020 1.205 (1.029–1.409) 0.020
Mild liver disease 1.005 (0.758–1.314) 0.9694 1.192 (0.829–1.690) 0.333
Severe liver disease 1.204 (0.878–1.623) 0.2360 1.643 (1.090–2.451) 0.016
Peptic ulcer 1.283 (1.087–1.508) 0.0029 1.060 (0.885–1.264) 0.523
Chronic pulmonary disease 1.302 (1.161–1.459) <0.001 1.006 (0.883–1.144) 0.926
Moderate/severe kidney disease 1.203 (1.095–1.320) 0.0001 1.383 (1.231–1.553) <0.001
Connective tissue disease 0.556 (0.338–0.865) 0.0139 0.970 (0.573–1.563) 0.904
Paraplegia 1.152 (0.885–1.482) 0.2810 1.054 (0.779–1.410) 0.726
Dementia 1.364 (1.158–1.600) 0.0002 1.033 (0.864–1.231) 0.718
HIV 0.287 (0.016–1.415) 0.2253 0.562 (0.030–3.080) 0.590

*IDSA, Infectious Diseases Society of America; NA, not applicable; OAH, old age home.

Main Article

1These authors contributed equally to this work.

2These authors were co–principal investigators.

Page created: November 17, 2021
Page updated: November 17, 2021
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