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Risk factors for Clostridium difficile infection in the community: a case-control study in patients in general practice, Denmark, 2009–2011

  • L. M. SØES (a1) (a2) (a3), H. M. HOLT (a4), B. BÖTTIGER (a5) (a6), H. V. NIELSEN (a1), V. ANDREASEN (a3), M. KEMP (a4), K. E. P. OLSEN (a1), S. ETHELBERG (a2) and K. MØLBAK (a2)...

To identify risk factors for Clostridium difficile infection (CDI) in Danish patients consulting general practice with gastrointestinal symptoms, a prospective matched case-control study was performed; cases (N = 259) had positive cultures for toxigenic C. difficile and controls (N = 455) negative cultures. Data were analysed by conditional logistic regression. In patients aged ⩾2 years (138 cases), hospitalization [odds ratio (OR) 8·4, 95% confidence interval (CI) 3·1–23], consumption of beef (OR 5·5, 95% CI 2·0–15), phenoxymethylpenicillin (OR 15, 95% CI 2·7–82), dicloxacillin (OR 27, 95% CI 3·6–211), and extended spectrum penicillins (OR 9·2, 95% CI 1·9–45) were associated with CDI. In patients aged <2 years none of these were associated with CDI, but in a subgroup analysis contact with animals was associated with CDI (OR 8·1, 95% CI 1·0–64). This study emphasizes narrow-spectrum penicillins, and suggests beef consumption, as risk factors for CDI in adults, and indicates a different epidemiology of CDI in infants.

Corresponding author
*Author for correspondence: Ms. L. M. Søes, Department of Clinical Microbiology, Hvidovre Hospital, Kettegård Alle 30, DK-2650 Hvidovre, Denmark. (Email:
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Epidemiology & Infection
  • ISSN: 0950-2688
  • EISSN: 1469-4409
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