Risk factors for Clostridium difficile-associated diarrhoea in a burns intensive care unit

Abstract

Background: As survival in patients with severe burn has improved, incidence of infectious complications particularly Clostridium difficile-associated diarrhoea (CDAD) has been increasing. We investigated the risk factors for CDAD in burn population admitted to a Burn Intensive Care Unit (BICU). Methods: Out of a total of 570 study participants admitted to a BICU during the study period, 43 that developed diarrhoea were included in the study. After review of 67 stool samples from 43 study participants, submitted to the National Health Laboratory Service (NHLS) for Clostridium difficile (CD) testing, study participants who were positive were compared to a control group of study participants with diarrhoea who tested negative, via univariate analysis and multivariate logistic regression analysis. Results: 16 study participants tested positive for CD toxin. There were no significant differences in age, gender, burn size, depth of burn, number and duration of antibiotics used, choice of antibiotics, proton pump inhibitor (PPI) use, Human immunodeficiency virus (HIV) status, and mortality when CDAD group was compared to non-CDAD group. Logistic regression analysis accounting for gender, age, burn size, depth of burn, number and duration of antibiotics used, PPI use, and HIV infection did not identify any factor associated with CDAD in the burn population. Conclusion: Traditional risk factors for CDAD were not found to be associated with CDAD in burn population admitted to intensive care unit.

Keywords

• Clostridium difficile
• Diarrhoea
• Risk factors
• Burn
• South Africa