Emerg Infect Dis. 2022 May;28(5):932-939. doi: 10.3201/eid2805.212023.
We evaluated whether hospitalized patients without diagnosed Clostridioides difficile infection (CDI) increased the risk for CDI among their family members after discharge. We used 2001-2017 US insurance claims data to compare monthly CDI incidence between persons in households with and without a family member hospitalized in the previous 60 days. CDI incidence among insurance enrollees exposed to a recently hospitalized family member was 73% greater than enrollees not exposed, and incidence increased with length of hospitalization among family members. We identified a dose-response relationship between total days of within-household hospitalization and CDI incidence rate ratio. Compared with persons whose family members were hospitalized <1 day, the incidence rate ratio increased from 1.30 (95% CI 1.19-1.41) for 1-3 days of hospitalization to 2.45 (95% CI 1.66-3.60) for >30 days of hospitalization. Asymptomatic C. difficile carriers discharged from hospitals could be a major source of community-associated CDI cases.
我们评估了在出院后，没有诊断出艰难梭菌感染（CDI）的住院患者是否会增加其家庭成员感染 CDI 的风险。我们使用了 2001 年至 2017 年美国保险索赔数据，比较了在过去 60 天内有和没有家庭成员住院的家庭中每月 CDI 的发病率。与未暴露于最近住院家庭成员的保险参保者相比，暴露于最近住院家庭成员的参保者发生 CDI 的风险增加了 73%，且家庭成员的住院时间越长，发病率越高。我们发现了总住院天数与 CDI 发病率比值之间的剂量反应关系。与家庭成员住院时间<1 天的人相比，住院时间为 1-3 天的发病率比值从 1.30（95%CI 1.19-1.41）增加到>30 天的发病率比值为 2.45（95%CI 1.66-3.60）。从医院出院的无症状艰难梭菌携带者可能是社区相关 CDI 病例的主要来源。
