Alcohol Use as a Risk Factor for Clostridioides difficile

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 A retrospective cohort study was conducted within five 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. Using an adjusted model, patients with AUD had 2.36 times greater odds of C. diff compared to patients without AUD. The odds of C. diff were 1.88 times greater for those with AUD diagnoses alone compared to patients without AUD. The odds were 1.96 greater for those with AUD and active withdrawal compared to those without. 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. •Alcohol use disorder is associated with an increased risk of C. diff.•The risk of C. diff in the setting of alcohol use disorder increases with disease severity.•The awareness of a new significant risk factor for C. diff can lead to earlier interventions.