Volume 29, Number 5—May 2023
CME ACTIVITY - Synopsis
Trends in and Risk Factors for Recurrent Clostridioides difficile Infection, New Haven County, Connecticut, USA, 2015–2020
Chinenye M. Okafor, Paula Clogher, Danyel Olson, Linda Niccolai, and James Hadler
Table 3
Characteristics of participants with recurrent CDI, stratified by epidemiologic class, New Haven County, Connecticut, USA, 2015–2020*
| Characteristic | Total | Epidemiologic class |
p value | ||
|---|---|---|---|---|---|
| HCFO, n = 83 | CO-HCFA, n = 174 | CA, n = 258 | |||
| Year of recurrent CDI | <0.001 | ||||
| 2015 | 115 (22.3) | 17 (20.5) | 36 (20.7) | 62 (24.0) | |
| 2016 | 86 (16.7) | 6 (7.2) | 31 (17.8) | 49 (19.0) | |
| 2017 | 68 (13.2) | 9 (10.8) | 22 (12.6) | 37 (14.3) | |
| 2018 | 77 (15.0) | 10 (12.1) | 31 (17.8) | 36 (14.0) | |
| 2019 | 68 (13.2) | 5 (6.0) | 29 (16.7) | 34 (13.2) | |
| 2020 |
101 (19.6) |
36 (43.4) |
25 (14.4) |
40 (15.5) |
|
| Age, y, median (IQR) |
70.0 (23.0) |
74.0 (20.0) |
71.0 (23.0) |
68.0 (26.0) |
0.002 |
| Sex | 0.083 | ||||
| M | 175 (34.0) | 36 (43.4) | 61 (35.1) | 78 (30.2) | |
| F |
340 (66.0) |
47 (56.6) |
113 (64.9) |
180 (69.8) |
|
| Race | <0.001 | ||||
| White | 419 (81.4) | 70 (84.3) | 134 (77.0) | 215 (83.3) | |
| Black | 34 (6.6) | 5 (6.0) | 13 (7.5) | 16 (6.2) | |
| Asian, American Indian, or Pacific Islander | 1 (0.2) | 0 | 1 (0.6) | 0 | |
| Mixed race or unknown |
61 (11.8) |
8 (9.6) |
26 (14.9) |
27 (10.5) |
|
| Ethnicity | 0.007 | ||||
| Hispanic | 31 (6.5) | 2 (2.5) | 14 (8.7) | 15 (6.3) | |
| Non-Hispanic |
448 (93.5) |
77 (97.5) |
147 (91.3) |
224 (93.7) |
|
| Medical history | |||||
| Previous CDI | 101 (19.6) | 19 (22.9) | 29 (16.7) | 53 (20.5) | 0.435 |
| Immunocompromised | 182 (35.3) | 47 (56.6) | 71 (40.1) | 64 (24.8) | <0.001 |
| Cerebrovascular accident | 48 (9.3) | 13 (15.7) | 19 (10.9) | 16 (6.2) | 0.024 |
| Cognitive impairment or dementia | 49 (9.5) | 17 (20.5) | 19 (10.9) | 13 (5.0) | <0.001 |
| Malignancy |
144 (28.0) |
22 (26.5) |
67 (38.5) |
55 (21.3) |
<0.001 |
| Medication history | |||||
| Proton pump inhibitors | 190 (41.0) | 47 (58.0) | 74 (45.4) | 69 (31.5) | <0.001 |
| Histamine 2 receptor blockers | 85 (18.5) | 19 (23.5) | 37 (22.7) | 29 (13.4) | 0.031 |
| Antibiotics | 375 (72.8) | 73 (88.0) | 145 (83.3) | 157 (60.9) | <0.001 |
| Penicillins | 115 (22.3) | 28 (33.7) | 61 (35.1) | 26 (10.1) | <0.001 |
| Cephalosporins | 179 (34.8) | 56 (67.5) | 87 (50.0) | 36 (14.0) | <0.001 |
| Tetracyclines | 32 (6.2) | 7 (8.4) | 17 (9.8) | 8 (3.1) | 0.013 |
| Nitroimidazole | 88 (17.1) | 19 (22.9) | 45 (25.9) | 24 (9.3) | <0.001 |
| Nitrofurantoin | 21 (4.1) | 1 (1.2) | 10 (5.8) | 10 (3.9) | 0.012 |
| Immunotherapeutic agents |
190 (36.9) |
35 (42.2) |
68 (39.1) |
87 (33.7) |
0.292 |
| Clinical exposures | |||||
| Admitted | 264 (51.4) | 57 (68.7) | 113 (65.3) | 94 (36.4) | <0.001 |
| CDI as reason for admission | 143 (54.4) | 18 (31.6) | 69 (61.6) | 56 (59.6) | <0.001 |
| Emergency department visit | 216 (43.5) | 45 (54.9) | 102 (59.0) | 69 (28.5) | <0.001 |
| Dialysis | 29 (5.8) | 9 (11.0) | 14 (8.1) | 6 (2.5) | 0.005 |
| Surgery | 77 (15.5) | 22 (26.8) | 45 (26.0) | 10 (4.2) | <0.001 |
*Values are no. (%) except as indicated. CA, community-associated; CDI, Clostridioides difficile infection; CO-HCFA, community-onset healthcare facility–associated; HCFO, healthcare facility–onset; IQR, interquartile range.
Page created: February 14, 2023
Page updated: April 13, 2023
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