Risk factors may identify asymptomatic C. difficile carriers
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Asymptomatic Clostridioides difficile colonization is significantly associated with previous hospitalization, gastric acid suppression, tube feeding and corticosteroid use, according to a systematic review and meta-analysis.
“There is growing interest in the role of asymptomatic C. difficile-colonized patients as a potential source of transmission,” Abhishek Deshpande MD, PhD, of the Center for Value-Based Care Research at the Cleveland Clinic, told Healio. “However, few studies have specifically evaluated the risk factors for C. difficile colonization among hospitalized adults.”
According to the study, Deshpande and colleagues searched MEDLINE, Scopus, Web of Science and EMBASE from Jan. 1, 1975, to Feb. 15, 2020, for articles related to C. difficile colonization among hospitalized adults. Among more than 5,500 studies identified in the search, 19 showed multivariable analyses evaluating risk factors for asymptomatic colonization and were included in the study.
In the included studies, 1,588 adults were asymptomatically colonized with C. difficile. The analysis revealed that some factors were associated with an increased risk for colonization: hospitalization in the previous 6 months (OR = 2.18; 95% CI, 1.86-2.56), use of gastric acid suppression therapy within the previous 8 weeks (OR = 1.42; 95% CI, 1.17-1.73), tube feeding (OR = 2.02; 95% CI, 1.06-3.85) and corticosteroid use in the previous 8 weeks (OR = 1.58; 95% CI, 1.14-2.17).
According to Deshpande and colleagues, receipt of antibiotics in the previous 3 months was not significantly associated with a risk for colonization (OR = 1.37; 95% CI, 0.94-2.01).
“Recognition of these potential risk factors may assist in identifying asymptomatic carriers of C. difficile,” Deshpande said. “Early identification of asymptomatic carriers can potentially help clinicians to monitor these patients carefully for development of C. difficile infection and taking appropriate infection control measures to reduce transmission.”
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