Identification of risk factors for Clostridium difficile infection in older adult hospitalized patients with pressure ulcers.

Abstract

Background: Clostridium difficile (C. difficile) infection (CDI) is a common healthcare-associated infection. Older adult hospitalized patients with pressure ulcers are more susceptible because of low immunity and disordered flora, but their specific risk factors are unknown. This study hypothesizes that the use of antibiotics for more than 2 weeks, the use of proton pump inhibitors (PPIs), and the use of β-lactam antibiotics are independent risk factors for CDI in this population.

Aim: To determine the risk factors for CDI in hospitalized older adults with pressure ulcers.

Methods: A total of 120 older adults hospitalized with pressure ulcers from 2020 to 2023 were enrolled in the wound repair ward of the hospital. Stool samples were collected for anaerobic culture, C. difficile glutamate dehydrogenase (GDH) antigen and toxin detection, and multivariate logistic regression was used to analyze risk factors.

Results: Among 120 older adults hospitalized patients with pressure ulcers, 39 tested positive for C. difficile, with an incidence rate of 32.5%. Thirty-nine patients (32.5%) were positive for GDH antigen. Twelve patients (10.0%) were positive for toxin A/B. Multivariate analysis shows that the use of antibiotics for more than 2 weeks, the use of proton pump inhibitors, and the use of β-lactam antibiotics are independent risk factors for CDI (all P values < 0.05).

Conclusion: From 2020 to 2023, the incidence of CDI in 120 hospitalized older adult patients with pressure ulcers was 32.5%, and three independent risk factors were identified.