Clostridium difficile Among Hospitalized Patients Receiving Antibiotics A Case-Control Study

2005 ◽  
Vol 26 (8) ◽  
pp. 685-690 ◽  
Author(s):  
Scott Modena ◽  
Dilip Bearelly ◽  
Kenneth Swartz ◽  
Frank K. Friedenberg
Keyword(s):  
Intensive Care ◽  
Clostridium Difficile ◽  
Length Of Stay ◽  
Case Control Study ◽  
Macrolide Antibiotic ◽  
Univariate Analysis ◽  
Antibiotic Use ◽  
Case Control ◽  
Hospitalized Patients ◽  
Control Study

AbstractObjectives:Clostridium difficile is the most common cause of infectious nosocomial diarrhea and can be found in up to 30% of asymptomatic hospitalized patients. Our primary aim was to compare the clinical characteristics of hospitalized patients who received antibiotics and developed C. difficile-associated diarrhea (CDAD) with those of hospitalized patients who received antibiotics and did not develop the disease.Design:Case-control study comprising inpatients at a single institution.Patients:Case-patients were defined as patients who had diarrhea and tested positive for C. difficile. Control-patients (matched 4:1 to case-patients) were defined as patients who received antibiotics for at least 5 days and did not develop CDAD.Results:On univariate analysis, nine variables were associated with CDAD. Only three of the variables, need for intensive care, length of stay, and macrolide antibiotic use, were found to be significant (P < .05) on logistic regression analysis. The odds ratios for status as a CDAD case were 3.68 (CI95, 1.44 to 9.40) for stay in the intensive care unit and 1.03 (CI95, 1.02 to 1.05) for each day of hospital stay. Receipt of macrolide antibiotics reduced risk significantly; the odds ratio was 0.23 (CI95, 0.19 to 0.87).Conclusions:We identified need for intensive care and length of stay as important risk factors for the development of CDAD. We also identified macrolide antibiotic use as protective against its development. Patients receiving intensive care may represent a population to study for targeted prophylaxis.

Risk Factors forClostridium difficileInfection in a Hepatology Ward

2007 ◽  
Vol 28 (2) ◽  
pp. 202-204 ◽  
Author(s):  
Dominique Vanjak ◽  
Guillaume Girault ◽  
Catherine Branger ◽  
Pierre Rufat ◽  
Dominique-Charles Valla ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Clostridium Difficile ◽  
Autoimmune Hepatitis ◽  
Attack Rate ◽  
Case Control Study ◽  
Antibiotic Use ◽  
Case Control ◽  
Strain Typing ◽  
Control Study

During 2001,Clostridium difficileinfection was observed in 23 patients hospitalized in a hepatology ward (attack rate, 0.9%). Since strain typing ruled out a clonal dissemination, we performed a case-control study. In addition to antibiotic use as a risk factor, theC. difficileinfection rate was higher among patients with autoimmune hepatitis (P< .01).

Clostridium Difficile Infection in Haematology Patients Significantly Increases Length of Stay; A Case Control Study

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 2108-2108
Author(s):  
Louise Imlay-Gillespie ◽  
Caroline Dix ◽  
Ashley McEwan ◽  
Kelly Wong ◽  
Melanie Figtree ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clostridium Difficile ◽  
Length Of Stay ◽  
Clostridium Difficile Infection ◽  
Research Funding ◽  
Primary Outcome ◽  
Case Control Study ◽  
Case Control ◽  
Hematological Disorders ◽  
Control Study

Abstract Background Clostridium difficile infection (CDI) is an important and increasingly prevalent healthcare-associated infection. Strongly associated with antibiotic exposure, CDI may result in diarrhea, colitis and death-particularly in at-risk patients. While the incidence of both CDI and CDI-associated complications appears more common in hematology patients - the economic impact of CDI in this patient population has not been assessed. We report the results of a hospital-wide audit and case-control study of CDI incidence to assess length-of-stay (LOS). Methods Hospital wide CDI incidence was reviewed for the period 2010-2013. Medical records were assessed to determine total patient days per specialty and the incidence of CDI as reported on discharge coding data. Hematology cases had CDI confirmed by reviewing diagnostic samples for PCR or toxin. Clinical data was collected including basic demographics, risk factors and outcomes. Controls drawn from departmental database were matched for age, sex, malignancy and admission reason. Statistical analysis was performed with the primary outcome being length of stay (LOS). Results During the period of study hematology patients consistently had the highest incidence of CDI across the hospital. (Cumulative incidence per 10,000 patient days are shown in graph 1.) A case-control study of 79 patients was performed with no significant differences in baseline demographics between groups. The primary outcome of LOS was statistically significant with a mean of 25 days for CDI affected patients compared with 15 days (p = 0.02). Risk factors analysis revealed a trend towards statistical significance for those prescribed a H2 Blocker (RR 1.66 95% CI 1.12-2.45, p = 0.01) but no difference was seen for proton pump inhibitor (PPI) use or antibiotic presence or duration. Analysis of morbidity and mortality demonstrated an increased relative risk of pseudomembranous colitis for those exposed to CDI (RR 2.01, 95% CI 1.72-2.36, p<0.0001), a non-significant increase in GvHD in patients who had undergone allogeneic BMT (56% v 31%; RR 1.65 95%CI 0.82 - 3.32, p = 0.16) but no differences in intensive care admission or mortality. Discussion Of hospitalized patients the highest incidence of CDI is in patients with hematological disorders. In these patients CDI had a significant impact on health-care costs - increasing LOS by 10 days, on average, at a cost of $260USD per day. This means that in the three year study period, for hematology patients alone, the additional bed cost resulting from CDI was $630,000USD. The combined medical and economic burden of CDI in patients with hematological disorders is considerable and warrants further study of risk factors for CDI and strategies to reduce CDI infection and its nosocomial spread within hematology units. Figure 1. Figure 1. Disclosures Imlay-Gillespie: Novartis: Honoraria. Arthur:BMS: Honoraria; Amgen: Honoraria; Amgen: Honoraria. Mackinlay:Roche: Research Funding; Sanofi Aventis: Research Funding. Mulligan:Celgene: Consultancy, Honoraria; Janssen: Consultancy, Honoraria, Speakers Bureau; Sanofi Aventis: Research Funding; Roche: Consultancy, Honoraria, Research Funding, Speakers Bureau.

scholarly journals Severe acquired subglottic stenosis in neonatal intensive care graduates: a case–control study

2017 ◽  
Vol 103 (4) ◽  
pp. F349-F354 ◽  
Author(s):  
Rebecca E Thomas ◽  
Shripada C Rao ◽  
Corrado Minutillo ◽  
Shyan Vijayasekaran ◽  
Elizabeth A Nathan
Keyword(s):  
Risk Factors ◽  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Case Control Study ◽  
Surgical Intervention ◽  
Conditional Logistic Regression ◽  
Univariate Analysis ◽  
Case Control ◽  
Subglottic Stenosis ◽  
Control Study

ObjectiveTo analyse current incidence and risk factors associated with severe acquired subglottic stenosis (SASGS) requiring surgical intervention in neonates.DesignRetrospective case–control study.SettingSole tertiary children’s hospital.ParticipantsPatients who underwent surgical intervention for SASGS from January 2006 to December 2014. For each neonatal intensive care unit (NICU) graduate with acquired SASGS, two controls were selected (matched for gestation and year of birth).Main outcomes and measuresIncidences were calculated and cases and controls compared using conditional logistic regression analysis to identify risk factors for SASGS.ResultsThirty-seven NICU graduates required surgical intervention for SASGS of whom 35 were <30-week gestation at birth. The incidence of SASGS in surviving children who had required ventilation in the neonatal period was 27/2913 (0.93%). Incidence was higher in infants <28-week gestation (24/623=3.8%) compared with infants ≥28-week gestation (3/2290=0.13%; p=0.0001). On univariate analysis, risk factors for SASGS were: higher number of intubations (4 vs 2; p<0.001); longer duration ventilation (16 vs 9.5 days; p<0.001); unplanned extubation (45.7% vs 20.0%; p=0.007); traumatic intubation (34.3% vs 7.1%; p=0.003) and oversized endotracheal tubes (ETTs) (74.3% vs 42.9%; p=0.001). On multivariate analysis, risk factors for SASGS were: Sherman ratio >0.1 (adjusted OR (aOR) 6.40; 95% CI 1.65 to 24.77); more than five previous intubations (aOR 3.74; 95% CI 1.15 to 12.19); traumatic intubation (aOR 3.37; 95% CI 1.01 to 11.26).ConclusionsSASGS is a serious consequence of intubation for mechanical ventilation in NICU graduates, especially in preterm infants. Minimising trauma during intubations, avoiding recurrent extubation/reintubations and using appropriate sized ETTs may help prevent this serious complication.

Is It Clostridium difficile Infection or Something Else? A Case-control Study of 352 Hospitalized Patients With New-onset Diarrhea

2007 ◽  
Vol 100 (8) ◽  
pp. 782-786 ◽  
Author(s):  
Farrin A. Manian ◽  
Sangita Aradhyula ◽  
Sandy Greisnauer ◽  
Diane Senkel ◽  
Janice Setzer ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Case Control Study ◽  
Case Control ◽  
Hospitalized Patients ◽  
Control Study ◽  
New Onset
Sign in / Sign up

Export Citation Format

Share Document