Analysis of Clostridium difficile infection and risk factors in patients with clinical diarrhea in Ningxia region

OBJECTIVE To understand the status of Clostridium difficile infection（CDI） in inpatients with diarrhea in the General Hospital of Ningxia Medical University, and analyze the risk factors for the infection. METHODS A total of 530 stool samples from patients with diarrhea in General Hospital of Ningxia Medical University from Jan. 1, 2019 to Dec. 1, 2020 were collected and used for anaerobic culture and polymerase chain reaction（PCR） to detect toxin genes. The clinical medical records were compared by 1∶2 case-control studies（36 cases in the CDI group and 72 cases in non-CDI group） and the risk factors for CDI were analyzed. RESULTS Thirty-eight strains of Clostridium difficile（CD） were detected in 530 stool samples（detection rate of 7.2%, 38/530）, and 36 strains were toxin-producing CD strains（infection rate of 6.8%, 36/530）, mainly tcdA+tcdB+（29 strains, 80.6%）. Multivariate binary logistic regression analysis showed that the independent risk factor for CDI was hospitalization within six months（OR=5.612,95%CI 1.520-20.720,P=0.010）, gastrointestinal disease（OR=4.240,95%CI 1.189-15.123,P=0.026） and hepatobiliary disease（OR=6.253,95%CI 1.671-23.405,P=0.006）. CONCLUSION In order to prevent CDI, it is recommended that patients with independent risk factors of digestive tract disease and liver and gallbladder disease with hospitalization experience within six months should be clinically identified early, in order to prevent the infection and epidemic of Clostridium difficile in the hospital.