ArticleBMC infectious diseases2019
Risk factors for Clostridioides difficile infection and colonization among patients admitted to an intensive care unit in Shanghai, China.
Article in BMC infectious diseases, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 25 citations in OpenAlex.
- Randomized Controlled Trial of Oral Vancomycin Treatment in Clostridioides difficile-Colonized Patients.mSphere · 2021Trial
- Reliable delineation ofMicrobiology spectrum · 2026Article
- The hidden cost of antibiotics: microbial dysbiosis-induced SCFA imbalance and its underlying mechanisms.Frontiers in immunology · 2026Review
- Dietary Fiber Modulates the Window of Susceptibility to Clostridioides difficile Infection.Gastroenterology · 2025Article
- Risk Factors and Outcomes of Clostridioides difficile Infection in Respiratory Intensive Care Unit Patients.The clinical respiratory journal · 2025Article
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- Demographic characteristics and clinical and laboratory features of patients withIJID regions · 2025Article
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- Characteristics, Risk Factors, and Prevalence ofInfection and drug resistance · 2021Article
- Complete Genome Sequencing and Comparative Phenotypic Analysis Reveal the Discrepancy BetweenFrontiers in microbiology · 2021Article
- Risk factors and intestinal microbiota: Clostridioides difficile infection in patients receiving enteral nutrition at Intensive Care Units.Critical care (London, England) · 2020Article
- Molecular Epidemiology and Risk Factors ofFrontiers in cellular and infection microbiology · 2020Article
- Differences in antimicrobial resistance gene abundance and microbial diversity of the gut microbiome in patients on antibiotics enrolled in a clinical trial.Therapeutic advances in infectious diseaseArticle
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
Abstract
backgroundClostridioides difficile is considered the main pathogen responsible for hospital-acquired infections. This prospective study determined the prevalence, molecular epidemiological characteristics, and risk factors for C. difficile infection (CDI) and C. difficile colonization (CDC) among patients in the intensive care unit (ICU) of a large-scale tertiary hospital in China, with the aim of providing strategies for efficient CDI and CDC prevention and control.
methodsStool samples were collected and anaerobically cultured for C. difficile detection. The identified isolates were examined for toxin genes and subjected to multilocus sequence typing. Patients were classified into CDI, CDC, and control groups, and their medical records were analyzed to determine the risk factors for CDI and CDC.
resultsOf the 800 patients included in the study, 33 (4.12%) and 25 (3.12%) were identified to have CDI and CDC, respectively. Associations with CDI were found for fever (OR = 13.993), metabolic disorder (OR = 7.972), and treatment with fluoroquinolone (OR = 42.696) or combined antibiotics (OR = 2.856). CDC patients were characterized by prolonged hospital stay (OR = 1.137), increased number of comorbidities (OR = 36.509), respiratory diseases (OR = 0.043), and treatment with vancomycin (OR = 18.168). Notably, treatment with metronidazole was found to be a protective factor in both groups (CDI: OR = 0.042; CDC: OR = 0.013). Eighteen sequence types (STs) were identified. In the CDI group, the isolated strains were predominantly toxin A and toxin B positive (A + B+) and the epidemic clone was genotype ST2. In the CDC group, the dominant strains were A + B+ and the epidemic clone was ST81.
conclusionsThe prevalences of CDC and CDI in our ICU were relatively high, suggesting the importance of routine screening for acquisition of C. difficile. Future prevention and treatment strategies for CDC and CDI should consider hospital stay, enteral nutrition, underlying comorbidities, and use of combined antibiotics. Moreover, metronidazole may be a protective factor for both CDI and CDC, and could be used empirically.
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