Hospital acquired Clostridioides difficile infection and risk factors for severity in a university hospital: A prospective study.
BACKGROUND
Clostridioides difficile infection (CDI) is a well-known cause of health care-associated diarrhea. Data about CDI epidemiology of Turkey is limited. This study investigates CDI incidence, clinical characteristics, and factors associated with severe CDI in a tertiary care center university hospital.


METHODS
This is a case control study was conducted between 2012 and 2016. We included all patients, 18 years of age or more, with CDI diagnosis. For each patient diagnosed with CDI, information was collected concerning the severity of disease, treatment regimen, treatment response, disease recurrence, 30-day case fatality. Cases defined as severe hospital acquired CDI (HA-CDI) and controls defined as non-severe CDI patients.


RESULTS
We identified 100 cases of HA-CDI out of 111 patients. Total CDI incidence was 1.19/10,000 patient-days. The incidence decreased 32.5% during the study period. We identified severe CDI in 24% of patients. Age and admission to intensive care unit were independent risk factors for severe CDI.


CONCLUSION
This study reports a 5-year prospective epidemiology of CDI in a tertiary care center in Istanbul, Turkey. The findings of this study suggest that HA-CDI incidence and proportion of severe CDI is low compared to European and US literature. We believe that CDI is underreported, neglected but still an important health care associated infection in Turkey.
['Bilgin|Hüseyin|H|', 'Sayın|Elvan|E|', 'Gürün|Hande Perk|HP|', 'Tükenmez-Tigen|Elif|E|', 'Ülger Toprak|Nurver|N|', 'Korten|Volkan|V|']
D016022:Case-Control Studies D000082682:Clostridioides D016360:Clostridioides difficile D003015:Clostridium Infections D006785:Hospitals, University D006801:Humans D011446:Prospective Studies D012307:Risk Factors D014421:Turkey
Clostridioides difficile Epidemiology Turkey Severe Clostridioides difficile infection