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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 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.

Main Article

Page created: February 14, 2023
Page updated: April 13, 2023
Page reviewed: April 13, 2023
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