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• W2912288990 abstract "Introduction:Clostridium difficile infection (CDI) is the most common infectious cause of nosocomial diarrhea. Zinc deficiency has been associated with increased risk of recurrence of CDI after fecal microbiota transplant, but risk factors for low zinc levels have not been explored in the setting of CDI. Zinc supplementation decreases diarrhea duration, severity, and mortality during active diarrheal illness in children, and is thus a potential target for intervention in other diarrheal illnesses including CDI. Identifying patients with CDI at risk for zinc deficiency would allow for research into potential interventions to reduce CDI-associated morbidity and mortality. Methods: We reviewed patients with serum zinc value within 21 days following CDI diagnosis between September 2013 and September 2016 at our tertiary academic center. CDI was defined by the presence of diarrhea and positive C. difficile stool test. Subjects were categorized as either normal or deficient in zinc based on our institutional cutoff for normal serum zinc of 0.66 μg/mL. Logistic regression was performed to identify risk factors for zinc deficiency. Variables accounted for included basic demographics, number of CDIs within the preceding 6 months, severity of preceding CDI (non-severe vs. severe or severe-complicated), number of days between CDI diagnosis and zinc level, presence of inflammatory bowel disease (IBD), Charlson comorbidity index score, use of a proton-pump inhibitor, and use of a serum zinc-lowering drug. Results: Seventy-seven subjects with normal (n=40) or low (n=37) zinc were included. The population mean age was 61 (range 20 to 90) and included 53 women and 24 men. Independent predictors of zinc deficiency included severe or severe-complicated CDI (OR 10.955, 95% CI 1.762-68.115, P=0.010) and presence of IBD (OR 9.574, 95% CI 1.713-53.509, P=0.010). Neither the number of CDIs within the preceding 6 months (P=0.240) nor the number of days between CDI diagnosis and zinc level (P=0.281) predicted zinc deficiency. Conclusion: Severity of CDI and presence of IBD are independent risk factors for zinc deficiency. Low serum zinc following CDI may reflect a combination of diarrhea losses, residual inflammation, and protein-calorie malnutrition. The retrospective nature of our data collection prevents determination of causality. Further study is needed to determine the clinical implications of zinc deficiency following CDI, and should focus on individuals with IBD and severe CDI." @default.
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• W2912288990 date "2017-10-01" @default.
• W2912288990 modified "2023-09-27" @default.
• W2912288990 title "Risk Factors for Zinc Deficiency in the Setting of Recent Clostridium difficile Infection" @default.
• W2912288990 doi "https://doi.org/10.14309/00000434-201710001-00130" @default.
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