Background: Clostridium difficile infection (CDI) remains one of the major hospital acquired infections in the nation,\noften attributable to increased antibiotic use. Little research, however, exists on the prevalence and impact of CDI\non patient and hospital outcomes among populations requiring such treatment. As such, the goal of this study was\nto examine the prevalence, risk factors, and impact of CDI among pneumonia and urinary tract infection (UTI)\nhospitalizations.\nMethods: The Nationwide Inpatient Sample (2009ââ?¬â??2011), reflecting a 20% stratified sample of community hospitals in\nthe United States, was used. A total of 593,038 pneumonia and 255,770 UTI discharges were included. Survey-weighted\nmultivariable regression analyses were conducted to assess the predictors and impact of CDI among pneumonia and\nUTI discharges.\nResults: A significantly higher prevalence of CDI was present among men with UTI (13.3 per 1,000) as compared\nto women (11.3 per 1,000). CDI was associated with higher in-hospital mortality among discharges for pneumonia\n(adjusted odds ratio [aOR] for men = 3.2, women aOR = 2.8) and UTI (aOR for men = 4.1, women aOR = 3.4). Length of\nstay among pneumonia and UTI discharges were also double upon presence of CDI. In addition, CDI increased\nthe total charges by at least 75% and 55% among pneumonia and UTI discharges, respectively. Patient and hospital\ncharacteristics associated with CDI included being 65 years or older, Charlson Deyo index for comorbidity of 2 or more,\nMedicare as the primary payer, and discharge from urban hospitals, among both pneumonia and UTI discharges.\nConclusion: CDI occurs frequently in hospitalizations among those discharged from hospital for pneumonia and UTI,\nand is associated with increased in-hospital mortality and health resource utilization. Interventions to mitigate the\nburden of CDI in these high-risk populations are urgently needed.
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