Description:
<jats:p>Nosocomial infections with <jats:italic>Clostridioides (Clostridium) difficile</jats:italic> have become an emergent health threat. We sought to define risk factors for a <jats:italic>C. difficile</jats:italic> infection (CDI) beyond the widely known ones, such as antibiotic use and prior hospital stay. We therefore focused on a group of patients with diarrhea in order to identify risk factors for <jats:italic>C. difficile</jats:italic> infection among this symptomatic cohort. A total of 121 hospitalized patients from Seesen/Germany with diarrhea were included who submitted a stool sample and were interviewed about their socio-demographic background, lifestyle and state of health using a standardized questionnaire. Antibiotic potential of diuretics was examined by agar diffusion test. <jats:italic>C. difficile</jats:italic> was identified in 29 patients resulting in a prevalence of 24.0%. The infection was hospital-acquired in most cases (<jats:italic>p</jats:italic> &lt; 0.001, 82.1%; <jats:italic>n</jats:italic> = 23/28, versus 29/91, 31.9%). The generally accepted risk factor previous antibiotic use was confirmed in this study (<jats:italic>p</jats:italic> = 0.002, <jats:italic>n</jats:italic> = 23/28 CDI patients, 82.1%, versus <jats:italic>n</jats:italic> = 44/91 non-CDI patients, 48.4%). The following additional risk factors were identified: regular consumption of proton pump inhibitors; PPI (<jats:italic>p</jats:italic> = 0.011, <jats:italic>n</jats:italic> = 24/29, 82.8% vs. <jats:italic>n</jats:italic> = 52/92, 56.5%), CDI patients ate less vegetables (<jats:italic>p</jats:italic> = 0.001, <jats:italic>n</jats:italic> = 12/29, 41.4% vs. 69/92, 75.0%). The intake of the diuretic agent torasemid in patients with CDI (<jats:italic>p</jats:italic> = 0.005, <jats:italic>n</jats:italic> = 18/29, 62.1%) was higher than in patients without (<jats:italic>n</jats:italic> = 30/92, 32.6%). More patients with CDI had to undergo a surgery in the previous year (<jats:italic>p</jats:italic> = 0.022, <jats:italic>n</jats:italic> = 13/29, 44.8% vs. <jats:italic>n</jats:italic> = 21/92, 22.8%) and held more birds (<jats:italic>p</jats:italic> = 0.056, <jats:italic>n</jats:italic> = 4/29, 13.8%) than individuals of the negative group (<jats:italic>n</jats:italic> = 3/92, 3.3%). In conclusion, although no antibiotic potential was detected in diuretics, especially torasemid seems to have significant influence for the occurrence of a CDI as well as a nutrition poor in vegetables. A diet rich in vegetables represented a fourfold lower risk for a CDI (OR 0.240, CI (0.0720 - 0.796]).</jats:p>