Reductions in intestinal Clostridiales precede the development of nosocomial Clostridium difficile infection

Table 1 Characteristics of study patients

Variable	CDI cases (n = 25)	Controls (n = 25)
Age, mean years ± SD	70 ± 12.8	69 ± 12.5
Male sex	12 (48)	12 (48)
Charlson comorbidity index, median score (IQR)	1 (1–3)	2 (1–3)
Duration of hospitalization^a, median days (IQR)	7 (4–28)	11 (8–17)
Hospitalization in past 12 months	19 (76)	15 (60)
Reason for hospital admission
Cardiac problem	9 (36)	10 (40)
Gastrointestinal problem	10 (40)	6 (24)
Pulmonary problem	2 (8)	3 (12)
Renal disease	2 (8)	1 (4)
Other^b	2 (8)	5 (20)
Medication use^c
H2 blocker	7 (29)	4 (16)
Nonsteroidal anti-inflammatory drug	15 (65)	12 (48)
Proton-pump inhibitor	11 (46)	14 (56)
Steroid	3 (13)	1 (4)
Any antimicrobial agent	21 (91)	13 (52)
Cephalosporin^d	10 (42)	5 (20)
Fluoroquinolone^e	9 (38)	4 (16)
Macrolide	0 (0)	1 (4)
Penicillin	0 (0)	1 (4)
Penicillin with β-lactamase inhibitor	7 (30)	3 (12)
Vancomycin^f	5 (22)	3 (12)

Data are number (%) of subjects unless otherwise specified. CDI Clostridium difficile infection, SD standard deviation, IQR interquartile range. ^aDuration until CDI diagnosis for case patients or duration until discharge for control subjects. ^bOther reasons include acquired immunodeficiency syndrome, cancer, breast surgery, anemia, osteomyelitis, neurological or rheumatological problems. ^cDefined as use within 8 weeks before or during hospitalization, until stool collection. Information on steroid, nonsteroidal anti-inflammatory drug, any antimicrobial agent, penicillin with β-lactamase inhibitor and vancomycin use was available for 23 out of 25 case patients; information on other medications was available for 24 out of 25 case patients. None of the patients were exposed to probiotics, carbapenem, clindamycin, gatifloxacin, levofloxacin, linezolid, tetracycline or trimethoprim-sulfamethoxazole prior to stool collection. ^dIncludes exposure to first-, second-, and third-generation cephalosporins. ^eIncludes exposure to ciprofloxacin and moxifloxacin. ^fIntravenous administration.