biostudies-literatureUnknown13Lang VNiedersächsische Ministerium für Wissenschaft und KulturNosocomial infections with <i>Clostridioides (Clostridium) difficile</i> have become an emergent health threat. We sought to define risk factors for a <i>C. difficile</i> infection (CDI) beyond the widely known ones, such as antibiotic use and prior hospital stay. We therefore focused on a group of patients with diarrhea in order to identify risk factors for <i>C. difficile</i> infection among this symptomatic cohort. A total of 121 hospitalized patients from Seesen/Germany with diarrhea were included who submitted a stool sample and were interviewed about their socio-demographic background, lifestyle and state of health using a standardized questionnaire. Antibiotic potential of diuretics was examined by agar diffusion test. <i>C. difficile</i> was identified in 29 patients resulting in a prevalence of 24.0%. The infection was hospital-acquired in most cases (<i>p</i> < 0.001, 82.1%; <i>n</i> = 23/28, versus 29/91, 31.9%). The generally accepted risk factor previous antibiotic use was confirmed in this study (<i>p</i> = 0.002, <i>n</i> = 23/28 CDI patients, 82.1%, versus <i>n</i> = 44/91 non-CDI patients, 48.4%). The following additional risk factors were identified: regular consumption of proton pump inhibitors; PPI (<i>p</i> = 0.011, <i>n</i> = 24/29, 82.8% vs. <i>n</i> = 52/92, 56.5%), CDI patients ate less vegetables (<i>p</i> = 0.001, <i>n</i> = 12/29, 41.4% vs. 69/92, 75.0%). The intake of the diuretic agent torasemid in patients with CDI (<i>p</i> = 0.005, <i>n</i> = 18/29, 62.1%) was higher than in patients without (<i>n</i> = 30/92, 32.6%). More patients with CDI had to undergo a surgery in the previous year (<i>p</i> = 0.022, <i>n</i> = 13/29, 44.8% vs. <i>n</i> = 21/92, 22.8%) and held more birds (<i>p</i> = 0.056, <i>n</i> = 4/29, 13.8%) than individuals of the negative group (<i>n</i> = 3/92, 3.3%). In conclusion, although no antibiotic potential was detected in diuretics, especially torasemid seems to have significant influence for the occurrence of a CDI as well as a nutrition poor in vegetables. A diet rich in vegetables represented a fourfold lower risk for a CDI (OR 0.240, CI (0.0720 - 0.796]).Frontiers in microbiology840846https://www.ebi.ac.uk/biostudies/studies/S-EPMC8963458biostudies-literatureRisk Factors of Patients With Diarrhea for Having <i>Clostridioides (Clostridium) difficile</i> Infection.PMC8963458Gunka KGroß UOrtlepp JRLang VZimmermann OfalseRisk Factors of Patients With Diarrhea for Having <i>Clostridioides (Clostridium) difficile</i> Infection.Nosocomial infections with <i>Clostridioides (Clostridium) difficile</i> have become an emergent health threat. We sought to define risk factors for a <i>C. difficile</i> infection (CDI) beyond the widely known ones, such as antibiotic use and prior hospital stay. We therefore focused on a group of patients with diarrhea in order to identify risk factors for <i>C. difficile</i> infection among this symptomatic cohort. A total of 121 hospitalized patients from Seesen/Germany with diarrhea were included who submitted a stool sample and were interviewed about their socio-demographic background, lifestyle and state of health using a standardized questionnaire. Antibiotic potential of diuretics was examined by agar diffusion test. <i>C. difficile</i> was identified in 29 patients resulting in a prevalence of 24.0%. The infection was hospital-acquired in most cases (<i>p</i> < 0.001, 82.1%; <i>n</i> = 23/28, versus 29/91, 31.9%). The generally accepted risk factor previous antibiotic use was confirmed in this study (<i>p</i> = 0.002, <i>n</i> = 23/28 CDI patients, 82.1%, versus <i>n</i> = 44/91 non-CDI patients, 48.4%). The following additional risk factors were identified: regular consumption of proton pump inhibitors; PPI (<i>p</i> = 0.011, <i>n</i> = 24/29, 82.8% vs. <i>n</i> = 52/92, 56.5%), CDI patients ate less vegetables (<i>p</i> = 0.001, <i>n</i> = 12/29, 41.4% vs. 69/92, 75.0%). The intake of the diuretic agent torasemid in patients with CDI (<i>p</i> = 0.005, <i>n</i> = 18/29, 62.1%) was higher than in patients without (<i>n</i> = 30/92, 32.6%). More patients with CDI had to undergo a surgery in the previous year (<i>p</i> = 0.022, <i>n</i> = 13/29, 44.8% vs. <i>n</i> = 21/92, 22.8%) and held more birds (<i>p</i> = 0.056, <i>n</i> = 4/29, 13.8%) than individuals of the negative group (<i>n</i> = 3/92, 3.3%). In conclusion, although no antibiotic potential was detected in diuretics, especially torasemid seems to have significant influence for the occurrence of a CDI as well as a nutrition poor in vegetables. A diet rich in vegetables represented a fourfold lower risk for a CDI (OR 0.240, CI (0.0720 - 0.796]).2022-01-01T00:00:00Z20222025-04-19T00:40:51.544Z2025-04-07T11:44:55.183ZS-EPMC89634583535970810.3389/fmicb.2022.840846