Clostridium difficile Infection Does Not Impact Outcomes in Stroke Patients

Area of Science:

• Neurology
• Infectious Diseases
• Critical Care Medicine

Background:

• Limited data exists on Clostridium difficile infection (CDI) in stroke patients.
• This study examines CDI incidence, characteristics, and outcomes across different stroke types: ischemic stroke (IS), intracerebral hemorrhage (ICH), and aneurysmal subarachnoid hemorrhage (SAH).

Purpose of the Study:

• To investigate the incidence and clinical features of CDI in patients following various types of stroke.
• To determine if CDI impacts patient outcomes, including mortality and functional status.

Main Methods:

• Retrospective analysis of a hospital database from 2010-2014.
• Inclusion of patients with IS, ICH, or SAH who underwent C. difficile testing (CDT) via polymerase chain reaction.
• Collection of demographic, clinical, and outcome data, with fever defined as temperature >101°F.

Main Results:

• Overall CDI incidence was 2.5%, with higher rates in SAH (6.5%) compared to ICH (2.9%) and IS (1.8%).
• Male sex and steroid use were associated with positive CDT results (P=0.0112 and P=0.0273, respectively).
• Leukocytosis and fever were infrequent on diagnosis day (61% and 71% respectively), and CDI did not affect length of stay, mortality, or functional outcomes.

Conclusions:

• CDI incidence following stroke is low, with the highest occurrence in SAH patients.
• Male gender and steroid use are risk factors for positive CDI tests in this population.
• CDI does not appear to significantly alter clinical outcomes or mortality in stroke patients.