The epidemiology of healthcare acquired Clostridioides difficile associated diarrhea in a healthcare facility in Saudi Arabia

Abstract

Background: Clostridium difficile-associated diarrhea (CDAD) is the most frequent cause of nosocomial infectious diarrhea and can result in conditions ranging from mild diarrhea to toxic megacolon and pseudomembranous colitis. Aim of the study: Reducing the occurrence of clostridium difficile-associated diarrhea (CDAD) in King Fahad Medical City and improve its outcome. Methods: A retrospective analysis was conducted, and data were collected from medical records of male and female patients aged > 14 years with positive NAAT results for C. difficile toxin genes and clinical signs and symptoms in King Fahad Medical City, Riyadh, from Jan 2021 to Dec 2022 were included in the study while patients with diarrhea due to chronic CDIs, previous surgeries, and patients with incomplete records were excluded to assess the prevalence, risk factors, recurrence, and complications of CDAD.
Results: Antibiotics and proton-pump inhibitors were the commonest risk factors for Clostridium difficile infection (86.2%) for each. Most of the studied group (91.7%) had diarrhea as the main symptom while hypotension was the commonest complication of Clostridium difficile infection, (30.3%). The older patients, the presence of malignancy, previous antibiotics, previous PPI, shock, and occurrence of relapse were statistically significantly associated with mortality due to Clostridium difficile infection (p-value 0.002, 0.01, 0.01, 0.001 &0.004) respectively. Conclusion: Older age, antibiotics, PPIs, and the presence of malignancy were risk factors for Health-care acquired infection Clostridium difficile-associated diarrhea for adults hospitalized for more than 2 calendar days after admission (Health-care acquired infection) in King Fahad Medical City.