Incidence and risk factors for hospital-acquired Clostridium difficile infection among inpatients in an orthopaedic tertiary care hospital

The aim of this retrospective study was to identify risk factors for hospital-acquired Clostridium difficile infection (HA-CDI) in orthopaedic patients. Thirty-two HA-CDI cases were each matched with two controls. Incidence rate was 0.33 cases per 1000 patient-days. Univariate analyses showed that surgery >24 h after admission, antibiotics for treatment, and proton pump inhibitors were associated with HA-CDI. Multivariate analyses revealed that surgery >24h after admissionwas associated with HA-CDI. Patients hospitalized before surgery had a greater risk of HA-CDI, suggesting opportunities to reduce environmental exposure to C. difficile by timelier preoperative medical optimization in the outpatient setting. (C) 2012 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.