# Molecular epidemiology and clinical differentiation between Clostridioides difficile infection and colonization across three chicago medical centers

## TL;DR

This study examines how to distinguish Clostridioides difficile infection from colonization in patients at three Chicago medical centers.

## Contribution

The study identifies recent antibiotic use as a predictor of true infection and reports a shift in dominant C. difficile strain.

## Key findings

- 27.2% of patients with positive C. difficile tests were colonized, not infected.
- Recent antibiotic use was strongly associated with true infection (adjusted odds ratio: 4.38).
- REA group Y became the dominant C. difficile strain, replacing BI.

## Abstract

In a retrospective cohort study at three Chicago academic medical centers, 22/81 (27.2%) patients with a clinically adjudicated positive C. difficile test result were colonized. Recent antibiotic usage predicted true infection (adjusted odds ratio: 4.38 for infection). Restriction endonuclease analysis(REA) group Y (29.3%) replaced BI (9.3%) as the dominant strain.