The researchers used a clinical data warehouse at a four-hospital healthcare organization to gather information on inpatients who contracted C. difficile and were available for 56 days of follow-up. Data was collected from January 2006 through October 2010 and revealed a 23.9 percent rate of infection relapse, defined as a positive test of C. difficile between 15 and 56 days after the initial test.
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The researchers identified the following factors associated with risk of relapse:
• Age
• Fluoroquinolone exposure in the 90 days before diagnosis
• Intensive care unit stay in the 30 days before diagnosis
• Cephalosporin exposure after diagnosis
• Proton pump inhibitor exposure after diagnosis
• Metronidazole exposure after diagnosis
The authors also determined that a prediction model in an electronic health record would flag 14.6 percent of CDI episodes at risk for relapse.
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