Session Information
Date: Thursday, November 14, 2019
Session Title: General Rehabilitation Research Report & Practice Management and Leadership Case Report
Session Time: 12:30pm-2:00pm
Location: Research Hub - Kiosk 2
Disclosures: Leila Ettefagh, MD: Nothing to disclose
Objective: Clostridium difficile infection (CDI) is a major health-care problem as far as prevalence, mortality and morbidity especially in older population admitted to acute inpatient rehabilitation facilities (IRF). Efforts for CDI prevention, early detection, isolation and treatment should be high priorities.
Design: Retrospective case-control study.
Setting: University based free standing acute IRF.
Participants: Of all patients admitted to our IRF between December 2014 and September 2018, 22 cases were found positive for clostridium difficile polymerase chain reaction assay recruited from the infectious disease control database. 66 control patients were matched on age, sex and date of admission. Male and female in cases and controls were 13(59.1%) and 9(40.9%) with mean age of (64.1±11.87) and (63.7±10.6) years in cases and controls, respectively.
Interventions: Not applicable
Main Outcome Measures: To identify the prevalence of CDI and its related clinical risk factors.
Results: Out of 3725 patients admitted to our acute IRF, 5(0.13 %) were admitted with CDI and 17(0.45 %) were diagnosed with CDI during their rehab stay (8.3±7.11 days to rehab admission date) yielding a total CDI prevalence of (0.6 %). There were statistically significant difference between the two groups as far as recent antibiotic therapy specifically with cephalosporins (P0.005, OR4.02, CI95%1.4-11.10) and penicillins (FE0.02, OR4.5, CI95%1.2-16.9), use of proton pump inhibitors (PPIs) (P0.007, OR4.3, CI95%1.4-13.1), history of gastrointestinal (GI) disease (P0.000, OR7.6, CI95%2.4-20.8), current tube feeding (FE0.014, OR5.8, CI95%1.4-23.25), rehab admission diagnosis of debility (P0.01, OR3.4, CI95%1.2-9.3) and active renal failure (P0.02, OR3.3, CI95%1.12-8.33). Patients with CDI compare to their control group have had more acute hospital transfers (22.7 %) vs (12.1%)(FE0.29, OR2.1, CI95%0.6-7.3) and longer rehab stay (17.95 ± 9.8) vs (13.83 ± 6.3) days (P0.055), however not statistically significant.
Conclusions: Recent antibiotic therapy with cephalosporins and penicillins, PPIs use, current tube feeding, history of GI disease, renal failure and rehab admission diagnosis of debility were the most frequent CDI risk factors. Broad spectrum antibiotics and PPIs must administer with caution to prevent CDI.
Level of Evidence: Level III
To cite this abstract in AMA style:
Ettefagh L, Monfared H, Hemami MR, Burke DT. Prevalence of Clostridium Difficile Infection and Its Clinically Relevant Factors in an Acute Inpatient Rehabilitation Facility: A Case-control Study [abstract]. PM R. 2019; 11(S2)(suppl 2). https://pmrjabstracts.org/abstract/prevalence-of-clostridium-difficile-infection-and-its-clinically-relevant-factors-in-an-acute-inpatient-rehabilitation-facility-a-case-control-study/. Accessed May 15, 2025.« Back to AAPM&R Annual Assembly 2019
PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/prevalence-of-clostridium-difficile-infection-and-its-clinically-relevant-factors-in-an-acute-inpatient-rehabilitation-facility-a-case-control-study/