Clostridium difficile Infection Among Hospitalized Chronic Hepatitis B Virus-Infected Patients in a Chinese Hospital

Background: Liver disease represents a risk factor for Clostridium difficile infection (CDI). However, CDI predisposition and its incidence in patients with chronic hepatitis B (CHB) have not been well-characterized. Objectives: This study aimed at determining the incidence and risk factors of CDI in CHB patients without cirrhosis. Methods: A retrospective case-control study was conducted on hospitalized patients in a Chinese tertiary hospital between June 2010 and June 2016. Results: A total of 105 CHB patients without cirrhosis were included in the present study. Among these patients, 35 (33%) patients developed hospital-acquired CDI. A total of 35 toxigenic C. difficile strains were assigned to 15 different STs by multi-locus sequence typing (MLST). Multivariate analysis indicated that prolonged hospital stay (OR: 1.045; 95% CI: 1.006 to 1.086) and higher Charlson scores on admission (OR: 3.063; 95% CI: 1.602 to 5.857) were independent factors for the development of CDI among CHB patients without cirrhosis. Conclusions: A high incidence of CDI was detected in this cohort of CHB patients. Both the prolonged hospital stay and higher Charlson scores made CHB patients more susceptible to hospital-acquired CDI. Greater emphasis on infection control measures and antimicrobial stewardship in patients with CHB during hospital admission is needed.