Characteristics, Risk Factors, and Prevalence of Clostridioides difficile Among Hospitalized Patients in a Tertiary Care Hospital in Palestine

Abstract

Abdallah Damin Abukhalil,1 Liana AbuKhdeir,1 Malak Hamed,1 Ni’meh Al Shami,1 Hani A Naseef,1 Banan M Aiesh,2 Ali Sabateen2 1Pharmacy Department, Faculty of Pharmacy, Nursing and Health Professions, Birzeit University, Birzeit, West Bank, Palestine; 2An-Najah National University Hospital, Nablus, PalestineCorrespondence: Abdallah Damin AbukhalilPharmacy Department, Faculty of Pharmacy, Nursing and Health Professions, Birzeit University, P.O. Box 14, Birzeit, West Bank, PalestineTel [phone]Fax [phone]Email [email protected]: Clostridioides difficile is one of the most important nosocomial infection pathogens. It is linked with many risk factors. Unfortunately, many studies have been conducted in different countries to address the Clostridioides difficile infections (CDI), and no studies have been conducted in Palestine. This study aims to identify the prevalence and possible risk factors associated with CDI.Patients and Methods: This was a retrospective descriptive study conducted at the An-Najah National University Hospital (NNUH) in Palestine. Data were collected for patients diagnosed with CDI who tested positive for GDH, toxins A and B between January 2018 and April 30, 2021. In addition, patient characteristics and risk factors associated with CDI were analyzed.Results: A total of 593 participants were included in the study; 53% had hospital-acquired CDI. There was an insignificant association between participant age and CDI risk. Most patients had mild to moderate infections. Sixty-three percent of the participants were immunocompromised. About 58.5% used an antibiotic agent two weeks before CDI, and 67% were on a proton pump inhibitor (PPI). About 61.3% of patients were treated according to IDSA 2017 guidelines, and 94% responded adequately to the treatment provided.Conclusion: There was an increased prevalence of community-acquired CDI, with a prevalence almost equal to that of hospital-acquired. In addition, most of the participants were immunocompromised. The risk factors for CDI, such as antibiotics and PPI use, were also observed with high prevalence among positive patients. Antimicrobial stewardship and the appropriate use of acid suppressors are warranted.Keywords: Clostridium difficile infection, Clostridium difficile risk factors, community-acquired CDI, hospital-acquired CDI, PPI, antibiotics

Keywords

• clostridium difficile infection
• clostridium difficile risk factors
• community-acquired cdi
• hospital acquired cdi
• ppi
• antibiotics