Clostridium difficile infection risk factors

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Risk Factors

• Most antibiotics, including metronidazole, can be associated with C. diff infection, though the most commonly implicated are ampicillin, clindamycin, and the cephalosporins. Antibiotics only rarely associated with infection include parenteral antibiotics, tetracyclines, chloramphenicol, metronidazole and vancomycin. Onset is usually during or shortly after a course of antibiotics.
• Patients who have been staying long-term in a hospital or a nursing home have a higher likelihood of being colonized by this bacterium. Hospitalized patients are more likely to infected if their roommates are infected. C. diff can be cultured from many surfaces in the hospital room, and spores have been identified everywhere, including toilets, floors, mops, scales, furniture, etc. Health care workers commonly carry the organism on their hands, clothing and stethoscopes, though they are not usually fecal carriers.
• Hospital outbreaks are common.
• Newborns are often infected, but are asymptomatic. By 24 months of age, over half of toddlers have immunoglobulins to toxins A and B.