NEJM Audio Summary - Nov 3, 2011

Excerpted Script

"Host and Pathogen Factors for Clostridium difficile Infection and Colonization" by Vivian Loo, from McGill University Health Centre, Montreal, Quebec, Canada.
This study identified host and bacterial factors associated with health care–associated acquisition of Clostrium difficile infection and colonization. Of 4143 patients admitted to the hospitals in Quebec, Montreal, 2.8% and 3.0% had health care–associated C. difficile infection and colonization, respectively. Older age and use of antibiotics and proton-pump inhibitors were significantly associated with health care–associated C. difficile infection. Hospitalization in the previous 2 months; use of chemotherapy, proton-pump inhibitors, and H2 blockers; and antibodies against toxin B were associated with health care–associated C. difficile colonization. Among patients with health care–associated C. difficile infection and those with colonization, 62.7% and 36.1%, respectively, had the North American PFGE type 1 (NAP1) strain. In this study, health care–associated C. difficile infection and colonization were differentially associated with defined host and pathogen variables. The NAP1 strain was predominant among patients with C. difficile infection, whereas asymptomatic patients were more likely to be colonized with other strains. (188 words/ 97sec = 116 wpm)

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