Statin Use Not Associated with Risk of Hospital-Onset C. difficile Infection

PHILADELPHIA, PA—Statin use was not associated with hospital-onset Clostridium difficile infection, reported Ahmad Ramy Elashery, MD, from Internal Medicine, Greater Baltimore Medical Center, Baltimore, MD, at IDWeek 2014.

C. difficile infection is the most common hospital acquired infection, outnumbering the incidence for methicillin-resistant Staphylococcus aureus,” reported Dr. Elashery. Statin use has been shown to have protective and harmful in various studies. Some have shown that increased statin use over time is associated with increasing incidence of C. difficile infection. However, other observational studies have shown a reduced risk of C. difficile infection with prior statin exposure, as well as a reduced incidence seen in patients taking statins.

Dr. Elashery and team sought to evaluate the association between statin use and hospital-onset C. difficile infection. A total of 269 cases and 538 controls were included in the retrospective case-control study conducted in a 310-bed suburban community hospital, from October 2005 through September 2012. 

Hospital-onset C. difficile infection was defined as patients developing diarrheal illness beyond 48 hours of hospital admission and tested positive for C. difficile in stool assay (enzyme immune assay for toxin A and B or polymerase chain reaction for toxin producing gene). In the study, controls were matched for age, gender, proton pump inhibitor use, length of hospital stay, and Elixhauser comorbidity index. 

Statin use was reviewed during the patient's hospital stay and/or before admission.  From the case group, 32% (85/269) were taking statins, and 34.8% (187/538) from the control group were taking statins. The length of hospital stay was found to be 12 days for both case and control groups (IQR 8–17), and both groups had a mean modified Elixhauser comorbidity measure of 19. 

Results showed that statin use was not associated with hospital-onset C. difficile infection (chi-square 0.024, P=0.8762, P=0.3694) with a relative risk of 0.91 (95% CI 0.73–1.22). 

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