Journal of Internal Medicine Concepts & Practice >

2025 , Vol. 20 >Issue 03: 216 - 223

DOI: https://doi.org/10.16138/j.1673-6087.2025.03.06

Original article

Clostridioides difficile toxin positivity prolongs hospital stay and increases costs for critically ill patients in emergency patients

  • YU Meiling ,
  • LI Jiaoyan ,
  • LI Jian ,
  • CHEN Ying ,
  • ZHAO Bing ,
  • MAO Enqiang ,
  • YANG Zhitao
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  • Department of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China

Received date: 2025-04-14

  Online published: 2025-09-01

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Abstract

Objective To explore the influence of Clostridioides difficile (C. difficile)positivity on clinical outcomes and identify associated risk factors in intensive care unit（ICU） patients. Methods A retrospective analysis was conducted on 2 036 patients admitted to the emergency ICU of Ruijin Hospital from 2013 to 2022, comparing outcomes between C. difficile-positive (n=225) and C. difficile negative (n=1 811) groups. Multivariate regression analysis was used to identify risk and protective factors. Results Significantly prolonged hospital stays (B=18.734 d, 95% CI: 14.683-22.785) and higher treatment costs (B=68 854.912, 95% CI: 46 579.159-91 130.665) in the C. difficile-positive group, with no statistically significant difference in mortality between groups. Multivariate analysis identified carbapenem use (OR=1.58, 95% CI: 1.16-2.15), bloodstream infection (OR=1.77, 95% CI: 1.17-2.66), and biliary tract infection (OR=1.79, 95% CI: 1.03-3.10) as risk factors for C. difficile positivity. Protective factors included metronidazole use (OR=0.58, 95% CI: 0.40-0.84), cephalosporin use (OR=0.54, 95% CI: 0.39-0.74), and female sex (OR=0.60, 95% CI： 0.44-0.83). Conclusions C. difficile positivity in critically ill patients did not affect mortality but prolonged hospitalization and increased costs. Both risk and protect factors for C. difficile are identified.

Key words： Clostridioides difficile; Intensive care unit; Antimicrobial stewardship; Infection prevention

Cite this article

YU Meiling , LI Jiaoyan , LI Jian , CHEN Ying , ZHAO Bing , MAO Enqiang , YANG Zhitao . Clostridioides difficile toxin positivity prolongs hospital stay and increases costs for critically ill patients in emergency patients[J]. Journal of Internal Medicine Concepts & Practice, 2025 , 20(03) : 216 -223 . DOI: 10.16138/j.1673-6087.2025.03.06

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