Alcohol use as a risk factor for Clostridioides difficile.

BACKGROUND

Clostridioides difficile (C. diff) is a pathogen of concern. Several risk factors are known, but patients without these risk factors continue to develop the disease. Alcohol use disorder (AUD) is known to disrupt the gut similar to antibiotics, which prompted this evaluation of the association between AUD and C. diff infection.

METHODS

A retrospective cohort study was conducted within 5 hospitals in a health system in Colorado. Adults 18 years of age or older who were seen in the Emergency Department or directly admitted to the hospital in 2022 and 2023 were included. A logistic regression was used to investigate the association between AUD and C. diff.

RESULTS

Using an adjusted model, patients with AUD had 2.36 times greater odds of C. diff compared with patients without AUD. The odds of C. diff were 1.88 times greater for those with AUD diagnoses alone compared with patients without AUD. The odds were 1.96 times greater for those with AUD and active withdrawal compared with those without.

CONCLUSIONS

There is a significant association between AUD and increased risk of C. diff, with that risk increasing in patients actively withdrawing. This information can be used to guide earlier interventions.