C. Difficile Infection Not Always Associated With Antibiotic Use, CMAJ

Main Category: Infectious Diseases / Bacteria / Viruses
Also Included In: MRSA / Drug Resistance
Article Date: 07 Oct 2008 - 2:00 PDT

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Community-acquired Clostridium difficile (C. difficile) infection occurred in a significant proportion of people with no recent exposure to antibiotics, with 53% having no exposure in the 45 days preceding hospitalization and 46% having no exposure in the preceding 90 days, according to a new study published in CMAJ. While C.difficile is mainly known as a hospital-acquired infection, the study participants, aged 65 and over, had not been hospitalized for at least 90 days before being admitted for C. difficile.

Dr. Sandra Dial and the team of McGill University-based authors conclude "testing for C. difficile should be consideredin community patients with diarrhea in whom a history of antibiotic exposure cannot be elicited."

In a related commentary, Dr. Ed Kuijper and Prof. Jaap van Disselof Leiden University in the Netherlands write that while the lack of antibiotic exposure in people admitted to hospital with C. difficile is interesting, it needs to be determined whether C.difficile is occurring in younger people without risk factors. Several studies suggest this may be the case. The authors state "there is an urgent need to identify and better characterize potential risk factors for community-acquired C.difficile infection to explain the large proportion of cases not linked to recent antibiotic therapy or hospital stays."

About CMAJ

CMAJ is the leading health sciences journal in Canada. CMAJ is a general medical journal publishing original research and review articles, commentaries and editorials, practice updates, an arts and ideas section and health news. Published continuously since 1911, new issues are uploaded on http://www.cmaj.ca every second Monday at 4:30 p.m. EST/EDT. http://www.cmaj.ca contains the complete editorial contents of CMAJ, supplemented by a variety of interactive features and additional content.

CMAJ is an open- and free-access journal - there are no author or page charges and access is provided free on the web (HighWire Press), http://www.cmaj.ca without registration. http://www.cmaj.ca has about 1 million requests and 250,000 page views per month. The Journal is part of the PubMed Central collection of journals http://www.pubmedcentral.nih.gov at the National Library of Medicine thus providing a guarantee of permanent archiving and open access. PubMed Central is now processing back issues of CMAJ to 1911.

CMAJ's impact factor - a measure of the scientific importance of articles published - has more than tripled since 1997 and is now 7.1.

The Journal receives about 2000 manuscripts a year (including letters to the editor and news articles). CMAJ's acceptance rate for unsolicited research and review articles is about 12%.

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