Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
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 HadlerComments to Author 
Author affiliations: Yale School of Public Health, New Haven, Connecticut, USA (C.M. Okafor, L. Niccolai, J. Hadler); Connecticut Emerging Infections Program, New Haven (P. Clogher, D. Olson, L. Niccolai, J. Hadler); Yale Institute of Global Health, New Haven (L. Niccolai)

Main Article

Table 2

Clinical characteristics of persons with incident CDI, stratified by occurrence of recurrent CDI, New Haven County, Connecticut, USA, 2015–2020*

Characteristic Total Recurrent CDI, n = 515 No recurrent CDI, n = 3,786 p value
Epidemiologic class
HCFO 610 (14.2) 83 (16.1) 527 (13.9) NS
CO-HCFA 1,234 (28.7) 174 (33.8) 1,060 (28.0) 0.006
CA
2,457 (57.1)
258 (50.1)
2,199 (58.1)
<0.001
Medical history
Previous CDI 837 (19.5) 101 (19.6) 736 (19.4) NS
Immunocompromised 1,397 (32.5) 182 (35.3) 1,215 (32.1) NS
Cerebrovascular accident 320 (7.4) 48 (9.3) 272 (7.2) NS
Cognitive impairment or dementia 337 (7.8) 49 (9.5) 288 (7.6) NS
Malignancy 903 (21.0) 144 (28.0) 759 (20.1) <0.001
HIV without AIDS 32 (0.7) 7 (1.4) 25 (0.7) NS
Diabetes mellitus 1,024 (23.8) 127 (24.7) 897 (23.7) NS
Chronic obstructive pulmonary disease 790 (18.4) 88 (17.1) 702 (18.5) NS
Chronic liver disease 229 (5.3) 27 (5.2) 202 (5.3) NS
Heart failure 544 (12.7) 67 (13.0) 477 (12.6) NS
Myocardial infarction 261 (6.1) 39 (7.6) 222 (5.9) NS
Peripheral vascular disease 213 (5.0) 33 (6.4) 180 (4.8) NS
Connective tissue disease 184 (4.3) 21 (4.1) 163 (4.3) NS
Gastrointestinal disease 809 (18.8) 88 (17.1) 721 (19.0) NS
Peptic ulcer disease 71 (1.7) 8 (1.6) 63 (1.7) NS
Morbid obesity
149 (3.5)
20 (3.9)
129 (3.4)
NS
Medication history prior to incident CDI
Proton pump inhibitors 1,487 (39.9) 190 (41.0) 1,297 (39.7) NS
Histamine 2 receptor blockers 598 (16.1) 85 (18.5) 513 (15.8) NS
Antibiotics 2,931 (68.2) 375 (72.8) 2,556 (67.5) 0.015
Penicillins 1,033 (24.0) 115 (22.3) 918 (24.3) NS
Cephalosporins 1,274 (29.6) 179 (34.8) 1,095 (28.9) 0.007
Tetracyclines 191 (4.4) 32 (6.2) 159 (4.2) 0.037
Nitroimidazole 614 (14.3) 88 (17.1) 526 (13.9) 0.052
Nitrofurantoin 99 (2.3) 21 (4.1) 78 (2.1) 0.004
Immunotherapeutic agents 1,707 (39.7) 190 (36.9) 1,517 (40.1) NS
Steroids 811 (18.9) 101 (19.6) 710 (18.8) NS
Chemotherapy
334 (7.8)
49 (9.5)
285 (7.5)
NS
Clinical exposures prior to incident CDI
Admitted 2,194 (51.1) 264 (51.4) 1,930 (51.0) NS
CDI as reason for admission 1,098 (50.1) 143 (54.4) 955 (49.5) NS
Emergency department visit 1,579 (37.7) 216 (43.5) 1,363 (36.9) 0.005
Dialysis 191 (4.6) 29 (5.8) 162 (4.4) NS
Surgery 561 (13.4) 77 (15.5) 484 (13.1) NS
Death
163 (3.8)
1 (0.2)
162 (4.3)
<0.001
Treatment of incident CDI
Total no. cases during 2018–2020 2,121 246 1,875
Received treatment 1,890 (89.1) 218 (88.6) 1,672 (89.2) NS
Vancomycin 1,344 (63.4) 162 (65.9) 1,182 (63.0) NS
Metronidazole 479 (22.6) 47 (19.1) 432 (23.0) NS
Fidaxomicin 28 (1.3) 3 (1.2) 25 (1.3) NS
Other antibiotic 7 (0.3) 1 (0.4) 6 (0.3) NS
Stool transplant 9 (0.4) 1 (0.4) 8 (0.4) NS
Probiotics 383 (18.1) 40 (16.2) 343 (18.3) NS
>1 treatment course duration 458 (21.6) 55 (22.4) 403 (21.5) NS

*Values are no. (%) except as indicated. CA, community-associated; CDI, Clostridioides difficile infection; CO-HCFA, community-onset healthcare facility–associated; HCFO, healthcare facility–onset; NS, not significant.

Main Article

Page created: February 14, 2023
Page updated: April 13, 2023
Page reviewed: April 13, 2023
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
file_external