Background: Clostridioides difficile (C. difficile) is an anaerobic bacterium associated
with considerable wide-spectrum colonic infections. Various risk factors are recognized to
increase the incidence of C. difficile infection (CDI) in certain age groups. COVID-19
pandemic and its association with CDI remains an area of research. Objectives: Our aim
is to investigate the risk factors and outcomes of CDI among hospitalized patients with
diarrhea with special consideration for COVID-19 patients. Results: The study included
1515 hospitalized patients with infectious diarrhea from 2017 to 2021, 195 (13%) of them
had positive CDI tests and 1320 (87%) were CDI-negative. The risk for CDI was higher
in the young adults aged between 18 and 35years (OR: 2.47, 95%CI: 1.37- 4.47, p=0.0028)
and older patients aged ≥ 56 years (OR: 1.95, 95% CI: 1.87-3.21, p=0.0084). Older
patients’ risk factors included stroke, administration of antibiotics, history of previous
hospital admission within one month, and cancer. While young adults receiving two
antibiotics were at greater risk of having CDI. 132 COVID-19 patients with diarrhea were
identified and 7 (5%) of them were CDI positive. Conclusions: Investigating the risk
factors of CDI in different age groups, including COVID-19 patients, is a crucial step to
developing a risk-based prophylactic strategy to reduce the cost and burden on the
healthcare system.