Defense Date


Document Type


Degree Name

Master of Public Health


Epidemiology & Community Health

First Advisor

Kate Lapane


BACKGROUND: Increasing rates of hospital acquired Clostridium difficile (CDI), as well as mortality owing to CDI, warrants further exploration of risk factors. Clostridium difficile bacteria typically produce toxins which inactivate the Rho proteins found in the colonic epithelium. Statins also disrupt Rho protein cell signaling functions. The objective of this study was to estimate the extent to which use of statins increases the risk of healthcare-acquired CDI. METHODS: Patients over 18 years of age admitted to hospitals contributing data to the University HealthSystem Consortium between 2002 and 2009 were eligible. We identified 25, 111 incident cases of CDI and matched up to 5 controls, matched on hospital, year of admission date, and age +/- 10 years (N=68,259). Patients with ICD-9-CM code of 008.45 who initiated a minimum three day course of either metronidazole or oral vancomycin on/after day 5 of admission were considered incident cases of CDI. RESULTS: Compared to non-users, users of any drug within the statin class as monotherapy were 0.63 times less likely to be classified as a case (95% CI = 0.60-0.66) adjusting for potential confounders. CONCLUSIONS: Our data did not support the Rho protein hypothesis. Rather it was consistent with a growing body of literature demonstrating reduced risk of infections with statin use. Statins’ pleiotropic properties may provide protection against CDI.


© The Author

Is Part Of

VCU University Archives

Is Part Of

VCU Theses and Dissertations

Date of Submission

May 2010

Included in

Epidemiology Commons