Kesiena Akpoigbe, MBBS1, Genao Alvaro, MD, FACG2, Michelle Thomas, MD2, Khaing Myint, MD2; 1Harlem Hospital Center, Bronx, NY; 2Harlem Hospital Center, New York, NY
Introduction: Clostridium difficile infection (CDI) poses a significant health concern amongst hospitalized patients in the United States. Underlying comorbidity significantly increases the burden of this infection especially in vulnerable populations. However, we have shown that the severity and infection rates are lower in African Americans treated at our community hospital. Unnecessary isolation protocols increase length of stay and overall cost of healthcare. The aim of this study is to determine factors that could predict CDI amongst African Americans at Harlem Hospital in an effort to avoid unnecessary isolation of patients. Methods: Information was collected from hospital charts of patients who were isolated for clostridium infection between January 2016 - December 2018. A total of 251 patients were isolated for suspected infection during this time. Baseline socio-demographic information, immune compromising comorbidities, days on antibiotic therapy, and length of hospital stay were extracted from clinical records. Descriptive, bivariate and multivariate logistic analysis was done. Results: 251 patients were isolated for CDI of which 48% were females and 52% male. 56 patients (22%) were confirmed positive and the median age was 61 with an IQR[20 -92]. Average length of hospital stay varies from one to 80 days with the average length of antibiotic use being 14 days [range 1-44]. There was no significant difference between the length of antibiotic therapy in those with CDI compared with those without. The average length of hospital stay for those with CDI was 33 days and for those without the infection was 34. Older patients were more significantly affected with CDI (p < 0.05). CDI increases by age 3% [OR (1.01 – 1.05)], Male 28% [OR (0.67-2.41)], days on antibiotics 1% [OR (0.99-1.02)], immune compromising status 48% [OR (0.79-2.810)]. Discussion: A large percentage of our hospital patients with diarrheal illness suspected of having CDI in fact test negative for the disease. Strict adherence to Centers for Disease Control and Prevention (CDC) guidelines may likely decrease unnecessary isolation protocols. The prevalence of CDI was influenced by the age of the patient as the risk increases with age. This might be attributed to a weaker immune response as shown.
Disclosures: Kesiena Akpoigbe indicated no relevant financial relationships. Genao Alvaro indicated no relevant financial relationships. Michelle Thomas indicated no relevant financial relationships. Khaing Myint indicated no relevant financial relationships.