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Clin Res Infect Dis. 2015;2(2). pii: 1017. Epub 2015 Aug 3.

Gender Differences in Non-Toxigenic Clostridium difficile Colonization and Risk of Subsequent C. difficile Infection.

Author information

1
Department of Internal Medicine, University of Michigan School of Medicine, USA.
2
University of Michigan School of Public Health, USA.
3
Department of Microbiology & Immunology, Montana State University, USA.
4
Department of Microbiology and Immunology, University of Michigan School of Medicine, USA.
5
Division of Infectious Diseases, Department of Medicine, Vanderbilt University School of Medicine, USA.

Abstract

OBJECTIVES:

Previous studies suggest that colonization with non-toxigenic Clostridium difficile may protect against toxigenic C. difficile infection (CDI), yet most of the studies were conducted in men. Therefore, we conducted a study to examine this hypothesis in both genders.

METHODS:

Patients (n=1492) were classified by disease status at baseline and observed for 1 year. Cox proportional hazards regression was used to evaluate CDI rates within 8 weeks post-baseline (short-term) and from 8 weeks to 1 year (long-term follow-up).

RESULTS:

During short-term follow-up, CDI rates were 5 times greater in females with non-toxigenic Clostridium difficile compared to females without C. difficile (hazard ratio (HR) = 5.13; 95% CI: 1.47-17.83). The comparable HR in males was 0.44 (95% CI: 0.04-4.43). During long term follow-up, CDI rates were similar in those with non-toxigenic C. difficile and those without C. difficile at baseline, for both females and males. Mortality rates were significantly lower for patients colonized by non-toxigenic C. difficile than those with toxigenic C. difficile at baseline, for both genders combined (HR=0.51; 95% CI: 0.28-0.92) and were similar to those with no C. difficile at baseline (HR=0.78; 95% CI: 0.43-1.41).

CONCLUSIONS:

There were gender differences in the short-term risk of CDI. Mortality was similar for patients colonized with non-toxigenic C. difficile and patients without C. difficile.

KEYWORDS:

Clostridium difficile; Gender; Infection; Mortality; Non-toxigenic strains

PMID:
28713874
PMCID:
PMC5508598

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