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Public Health


Srikanta K. Banerjee


AbstractClostridium difficile infection (CDI) is a major nosocomial threat to be reckoned with in the current health care setting in the United States. Advancing age, underlying chronic disease associated with inflammation (including Diabetes Mellitus Type I ([DMI]), Diabetes Type II ([DMII]), and obesity), trauma, immunodeficiency and other factors that diminish the overall health of an individual, and increase an individual’s susceptibility to CDI. The ecological framework was used to determine the relationship between geographic, chronic diseases and the occurrence of infectious diseases. To continue enhancing knowledge related to CDI susceptibility this quantitative study used the 2010 National Hospital Discharge Survey as the source of data to examine the relationship between specific health conditions, geographic location of the patient, and subsequent development of CDI in the acute care setting. Both established relationships and potential novel associations were explored utilizing International Classification of Disease-9 codes and evaluated for association with CDI. Binary logistic regression demonstrated that the independent variables of DM II (OR=1.17, 95% CI= 1.01-1.35, p < 0.05), advancing age, obesity, and a history of inflammatory bowel disease had a statistically significant influence over contracting CDI. Unanticipated results revealed an association between CDI and DMI, and a geographic association between patients admitted in the southern region of the United States and an increased susceptibility to CDI. The recognition of factors that make people more susceptible to Clostridium difficile infection will encourage a more personalized initial evaluation and a specific individualized course of treatment with improved outcomes regarding patient health and quality of life, resulting in significant positive social change in health care settings in the United States.

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