Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
Emerg Infect Dis. 2010 Feb;16(2):197-204. doi: 10.3201/eid1602.090953.
We determined estimated incidence of and risk factors for community-associated Clostridium difficile infection (CA-CDI) among patients treated at 6 North Carolina hospitals. CA-CDI case-patients were defined as adults (>18 years of age) with a positive stool test result for C. difficile toxin and no hospitalization within the prior 8 weeks. CA-CDI incidence was 21 and 46 per 100,000 person-years in Veterans Affairs (VA) outpatients and Durham County populations, respectively. VA case-patients were more likely than controls to have received antimicrobial drugs (adjusted odds ratio [aOR] 17.8, 95% confidence interval [CI] 6.6-48] and to have had a recent outpatient visit (aOR 5.1, 95% CI 1.5-17.9). County case-patients were more likely than controls to have received antimicrobial drugs (aOR 9.1, 95% CI 2.9-28.9), to have gastroesophageal reflux disease (aOR 11.2, 95% CI 1.9-64.2), and to have cardiac failure (aOR 3.8, 95% CI 1.1-13.7). Risk factors for CA-CDI overlap with those for healthcare-associated infection.
我们确定了在北卡罗来纳州的 6 家医院接受治疗的患者中社区获得性艰难梭菌感染 (CA-CDI) 的估计发病率和危险因素。CA-CDI 病例患者被定义为粪便检测出艰难梭菌毒素阳性且过去 8 周内无住院史的成年人 (>18 岁)。退伍军人事务部 (VA) 门诊患者和达勒姆县人群中的 CA-CDI 发病率分别为每 100000 人年 21 例和 46 例。VA 病例患者比对照组更有可能接受抗菌药物治疗（调整后的优势比[aOR]17.8，95%置信区间[CI]6.6-48），且近期有门诊就诊（aOR 5.1，95% CI 1.5-17.9）。与对照组相比，县病例患者更有可能接受抗菌药物治疗（aOR 9.1，95% CI 2.9-28.9），更有可能患有胃食管反流病（aOR 11.2，95% CI 1.9-64.2），并且更有可能患有心力衰竭（aOR 3.8，95% CI 1.1-13.7）。CA-CDI 的危险因素与医疗保健相关感染的危险因素重叠。
