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Risk Factors for Primary Clostridium difficile Infection; Results From the Observational Study of Risk Factors for Clostridium difficile Infection in Hospitalized Patients With Infective Diarrhea (ORCHID).
Davies, Kerrie; Lawrence, Jody; Berry, Claire; Davis, Georgina; Yu, Holly; Cai, Bing; Gonzalez, Elisa; Prantner, Ida; Kurcz, Andrea; Macovei, Ioana; Pituch, Hanna; Nováková, Elena; Nyc, Otakar; Gärtner, Barbara; Berger, Fabian K; Oleastro, Monica; Cornely, Oliver A; Vehreschild, Maria J G T; Pedneault, Louise; Wilcox, Mark.
Afiliación
  • Davies K; Healthcare Associated Infections Research Group, Leeds Teaching Hospitals NHS Trust and University of Leeds, Leeds, United Kingdom.
  • Lawrence J; Vaccine Research and Development, Pfizer Inc., Pearl River, NY, United States.
  • Berry C; Healthcare Associated Infections Research Group, Leeds Teaching Hospitals NHS Trust and University of Leeds, Leeds, United Kingdom.
  • Davis G; Healthcare Associated Infections Research Group, Leeds Teaching Hospitals NHS Trust and University of Leeds, Leeds, United Kingdom.
  • Yu H; Vaccine Research and Development, Pfizer Inc., Pearl River, NY, United States.
  • Cai B; Vaccine Research and Development, Pfizer Inc., Pearl River, NY, United States.
  • Gonzalez E; Vaccine Research and Development, Pfizer Inc., Pearl River, NY, United States.
  • Prantner I; Department of Hospital Epidemiology and Hygiene, National Center for Epidemiology, Budapest, Hungary.
  • Kurcz A; Department of Hospital Epidemiology and Hygiene, National Center for Epidemiology, Budapest, Hungary.
  • Macovei I; Cantacuzino National Medico-Military Institute for Research and Development, Bucharest, Romania.
  • Pituch H; Department of Medical Microbiology, Medical University of Warsaw, Warsaw, Poland.
  • Nováková E; Department of Microbiology and Immunology in Jessenius Faculty of Medicine Martin, Comenius University Bratislava, Martin, Slovakia.
  • Nyc O; Department of Medical Microbiology, Second Faculty of Medicine, Charles University in Prague and Motol University Hospital, Prague, Czechia.
  • Gärtner B; Germany National Reference Centre for Clostridiodies Clostridium difficile, Institute of Medical Microbiology and Hygiene, Saarland University of Medical Center, Homburg, Germany.
  • Berger FK; German National Reference Center for Clostridioides (Clostridium) Difficile, Institute of Medical Microbiology and Hygiene, Saarland University, Saarbrücken, Germany.
  • Oleastro M; Department of Infectious Diseases, National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal.
  • Cornely OA; Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Department I of Internal Medicine, Clinical Trials Center Cologne (ZKS Köln), University of Cologne, Cologne, Germany.
  • Vehreschild MJGT; Department I of Internal Medicine, Germany and German Centre for Infection Research (DZIF), University Hospital of Cologne, Partner Site Bonn-Cologne, Cologne, Germany.
  • Pedneault L; Vaccine Research and Development, Pfizer Inc., Pearl River, NY, United States.
  • Wilcox M; Healthcare Associated Infections Research Group, Leeds Teaching Hospitals NHS Trust and University of Leeds, Leeds, United Kingdom.
Front Public Health ; 8: 293, 2020.
Article en En | MEDLINE | ID: mdl-32766196
Background: There are inconsistent data on the risk factors for Clostridium difficile infection (CDI) in the literature. Aims: To use two C. difficile infection (CDI) case-control study groups to compare risk factors in hospitalized patients with diarrhea across different countries. Methods: A multi-center group of CDI cases/controls were identified by standardized testing from seven countries from the prior EUropean, multi-center, prospective bi-annual point prevalence study of CLostridium difficile Infection in hospitalized patients with Diarrhea (EUCLID). A second group of CDI cases/controls was identified from a single center in Germany [parallel study site (PSS)]. Data were extracted from the medical notes to assess CDI risk factors. Univariate analyses and multivariate logistic regression models were used to identify and compare risk factors between the two groups. Results: There were 253 and 158 cases and 921 and 584 controls in the PSS and EUCLID groups, respectively. Significant variables from univariate analyses in both groups were age ≥65, number of antibiotics (OR 1.2 for each additional antibiotic) and prior hospital admission (all p < 0.001). Congestive heart failure, diabetes, admission from assisted living or Emergency Department, proton pump inhibitors, and chronic renal disease were significant in PSS (all p < 0.05) but not EUCLID. Dementia and admitted with other bacterial diseases were significant in EUCLID (p < 0.05) but not PSS. Following multivariate analyses, age ≥ 65, number of antibiotics and prior hospital admission were consistently identified as CDI risk factors in each individual group and combined datasets. Conclusion: Our results show that the same CDI risk factors were identified across datasets. These were age ≥ 65 years, antibiotic use and prior hospital admission. Importantly, the odds of developing CDI increases with each extra antibiotic prescribed.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Clostridioides difficile / Infecciones por Clostridium Tipo de estudio: Clinical_trials / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Humans País/Región como asunto: Europa Idioma: En Revista: Front Public Health Año: 2020 Tipo del documento: Article País de afiliación: Reino Unido Pais de publicación: Suiza

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Clostridioides difficile / Infecciones por Clostridium Tipo de estudio: Clinical_trials / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Humans País/Región como asunto: Europa Idioma: En Revista: Front Public Health Año: 2020 Tipo del documento: Article País de afiliación: Reino Unido Pais de publicación: Suiza