scholarly journals The Epidemiology and Economic Burden ofClostridium difficileInfection in Korea

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Hyung-Yun Choi ◽  
So-Youn Park ◽  
Young-Ae Kim ◽  
Tai-Young Yoon ◽  
Joong-Myung Choi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Health Insurance ◽  
Clostridium Difficile ◽  
Old Age ◽  
Economic Burden ◽  
Economic Cost ◽  
Risk Groups ◽  
Antibiotic Use ◽  
Infection Prevalence ◽  
National Data

The prevalence ofClostridium difficileinfection and the associated burden have recently increased in many countries. While the main risk factors forC. difficileinfection include old age and antibiotic use, the prevalence of this infection is increasing in low-risk groups. These trends highlight the need for research onC. difficileinfection. This study pointed out the prevalence and economic burden ofC. difficileinfection and uses the representative national data which is primarily from the database of the Korean Health Insurance Review and Assessment Service, for 2008–2011. The annual economic cost was measured using a prevalence approach, which sums the costs incurred to treatC. difficileinfection.C. difficileinfection prevalence was estimated to have increased from 1.43 per 100,000 in 2008 to 5.06 per 100,000 in 2011. Moreover, mortality increased from 69 cases in 2008 to 172 in 2011. The economic cost increased concurrently, from $2.4 million in 2008 to $7.6 million, $10.5 million, and $15.8 million in 2009, 2010, and 2011, respectively. The increasing economic burden ofC. difficileinfection over the course of the study period emphasizes the need for intervention to minimize the burden of a preventable illness likeC. difficileinfection.

scholarly journals Neisseria meningitidis carriage and risk factors among teenagers in Suizhou city in China

2020 ◽  
Vol 148 ◽  
Author(s):  
Fei He ◽  
Hong mei Yang ◽  
Guo ming Li ◽  
Bing qing Zhu ◽  
Yating Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Population Density ◽  
Neisseria Meningitidis ◽  
Old Age ◽  
Age Groups ◽  
Significant Risk ◽  
Epidemiological Data ◽  
Significant Risk Factor ◽  
Antibiotic Use ◽  
Carriage Rate

Abstract Teenagers are important carriers of Neisseria meningitidis, which is a leading cause of invasive meningococcal disease. In China, the carriage rate and risk factors among teenagers are unclear. The present study presents a retrospective analysis of epidemiological data for N. meningitidis carriage from 2013 to 2017 in Suizhou city, China. The carriage rates were 3.26%, 2.22%, 3.33%, 3.53% and 9.88% for 2013, 2014, 2015, 2016 and 2017, respectively. From 2014 to 2017, the carriage rate in the 15- to 19-year-old age group (teenagers) was the highest and significantly higher than that in remain age groups. Subsequently, a larger scale survey (December 2017) for carriage rate and relative risk factors (population density, time spent in the classroom, gender and antibiotics use) were investigated on the teenagers (15- to 19-year-old age) at the same school. The carriage rate was still high at 33.48% (223/663) and varied greatly from 6.56% to 52.94% in a different class. Population density of the classroom was found to be a significant risk factor for carriage, and 1.4 persons/m2 is recommended as the maximum classroom density. Further, higher male gender ratio and more time spent in the classroom were also significantly associated with higher carriage. Finally, antibiotic use was associated with a significantly lower carriage rate. All the results imply that attention should be paid to the teenagers and various measures can be taken to reduce the N. meningitidis carriage, to prevent and control the outbreak of IMD.

Risk of Clostridium difficile-Associated Disease Among Patients Receiving Proton-Pump Inhibitors in a Quebec Medical Intensive Care Unit

2007 ◽  
Vol 28 (11) ◽  
pp. 1305-1307 ◽  
Author(s):  
Mathieu Beaulieu ◽  
David Williamson ◽  
Gilbert Pichette ◽  
Jean Lachaine
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Clostridium Difficile ◽  
Gastric Acid ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Medical Intensive Care Unit ◽  
Antibiotic Use ◽  
Medical Intensive Care

Our study was conducted to determine whether use of gastric acid-suppressive agents increased the risk of Clostridium difficile-associated disease (CDAD) in a medical intensive care unit of one of the first hospitals to be threatened by the current CDAD epidemic in Quebec, Canada. Our findings suggest that efforts to determine risk factors for CDAD should focus on other areas, such as older age and antibiotic use.

scholarly journals The Analysis of Risk Factors and Clinical-Demographic Characteristics of Patients with Clostridium Dificille Infection as Well as The Outcome of Their Treatment

2016 ◽  
Vol 17 (2) ◽  
pp. 139-144
Author(s):  
Ivana Raković ◽  
Biljana Popovska Jovicic ◽  
Andriana Bukonjic ◽  
Sara Petrovic ◽  
Petar Canovic ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Antibiotic Use ◽  
Demographic Characteristics ◽  
Medical Documentation ◽  
Hospital Treatment ◽  
Continuous Variables ◽  
Bacterial Strains ◽  
H2 Blockers

Abstract Pseudomembranous colitis is a frequent nosocomial infection associated with significant morbidity and mortality. Clostridium difficile infection incidence most frequently increases due to unreasonable antibiotic use and the appearance of new hypervirulent bacterial strains, which leads to prolonged hospitalization and an increase in the total cost of hospital treatment.This is a retrospective design study conducted at Clinical Centre Kragujevac from January to December 2014. The patient data were obtained from the protocol of the Virological Laboratory and from medical documentation. All statistical analyses were performed using the computer program SPSS. The descriptive statistical data are expressed as percentage values. Continuous variables are expressed as the arithmetic mean with the standard deviation.Clostridium difficile infection occurred more frequently with elderly patients (123 patients were over 65 years old). Out of 154 patients on antibiotic treatment, 110 patients were treated with a combination of two or more antibiotics from different pharmacological groups. The most represented antibiotics were from the cephalosporin (71.4%) and quinolone (46.3%) groups. A total of 85.8% of the patients used proton pump inhibitors and H2 blockers.Our results describe the clinical and demographic characteristics of patients with diagnosed Clostridium difficile infection. The most prevalent characteristics (age, antibiotic therapy, PPI and H2 blocker use), which other researchers have also mentioned as risk factors, were present in our study as well.

scholarly journals P799 Use of anti-TNF agents may reduce a risk of venous thromboembolism in Korean patients with inflammatory bowel disease: A nationwide population-based study from the National Health Insurance Database

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S627-S628
Author(s):  
H M Kim ◽  
S Y Kim ◽  
H S Kim ◽  
J K Lee ◽  
S H Park ◽  
...  
Keyword(s):  
Risk Factors ◽  
Inflammatory Bowel Disease ◽  
Health Insurance ◽  
Venous Thromboembolism ◽  
Old Age ◽  
National Health Insurance ◽  
Low Income ◽  
Population Based ◽  
Steroid Use ◽  
Inflammatory Bowel

Abstract Background Inflammatory bowel disease (IBD) has a risk of venous thromboembolism (VTE) compared with healthy controls, which justify prophylaxis in practice. There are few data on VTE in Asian IBD patients including Koreans. We aimed to investigate the incidence of VTE and the potential risk factors in Korean IBD patients. Methods A nationwide population-based cohort study was performed using claims data from the National Health Insurance service in Korea for 10 years, from 2006 to 2015. VTE, Crohn’s disease (CD) and ulcerative colitis (UC) were operationally defined by using ICD-10 codes, codes for Rare and Intractable Diseases registration, and pharmaceutical prescriptions for IBD-specific drugs. Control group was defined as age- and sex-matched health insurance subscribers without IBD for the same period. The hazard ratio (HR) for the risk of VTE was calculated after adjusting for covariates such as age, sex, rural area, comorbidities, Charlson Comorbidity Index (CCI), admission, and therapeutic drugs use for IBD using multivariate Cox proportional hazard regression. Results A total of 45,037 patients were diagnosed with IBD (13,850 CD and 31,187 UC), and 133,019 were defined as controls. VTE occurred in 411 (0.91%) in IBD, 106 (0.76%) in CD, and 305 (0.98%) in UC, whereas 641 (0.48%) in controls. In univariate analysis among IBD patients, old age (>59 years: HR = 6.256), female sex (HR = 1.537), low income (HR = 1.3090), high CCI (>3 score: HR = 4.053), steroid use (HR = 1.872), emergency care (HR = 1.513) and hospitalisation (HR = 1.352) significantly increased a risk of VTE. However, anti-TNF agent use (HR = 0.611) significantly decreased a risk of VTE. In multivariate analysis with adjustment among all subjects, CD (HR = 15.833) and UC (HR = 8.125) significantly increased a risk of VTE compared with controls. Conclusion Our study demonstrates that VTE is significantly high in Korean IBD patients compared with controls. In addition, old age, female sex, low income, high CCI, steroid use, emergency care, and hospitalisation are suggested as risk factors of VTE in IBD. Interestingly, use of anti-TNF agents may reduce risk of VTE, which should be considered for prophylaxis strategy suitable for Korean IBD patients.

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).

scholarly journals Clostridium difficile in Inflammatory Bowel Disease: A Retrospective Study

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
William Gillespie ◽  
Neil Marya ◽  
Julien Fahed ◽  
Gregory Leslie ◽  
Krunal Patel ◽  
...  
Keyword(s):  
Risk Factors ◽  
Inflammatory Bowel Disease ◽  
Retrospective Study ◽  
Clostridium Difficile ◽  
Bowel Disease ◽  
Biologic Therapy ◽  
Antibiotic Use ◽  
Extraintestinal Manifestations ◽  
Chi Squared ◽  
Inflammatory Bowel

Aim. To investigate the epidemiology and risk factors of Clostridium difficile infections (CDI) in patients with inflammatory bowel disease (IBD). Methods. This is a retrospective study of patients diagnosed with IBD. 1006 charts were screened and 654 patients met the inclusion criteria. Patients were divided into 2 cohorts based on the presence of prior diagnosis of CDI. Statistical analysis with Pearson’s chi-squared and two-sample t-test was performed. Results. The incidence of CDI among IBD patients was 6.7%. There was equal prevalence of CDI among Crohn’s disease (CD) (n=21, 49%) and ulcerative colitis (UC) (n=22, 51%). IBD patients acquired CDI at a mean age of 42.7 years, with 56% of infections acquired in the community and only 28% associated with healthcare. Only 30% of IBD patients with CDI had prior antibiotic use, and 16% had prior steroid use. IBD patients were significantly more likely to require biologic therapy (57% versus 37%, p<0.01) and have extraintestinal manifestations of IBD (43% versus 28%, p<0.02). Conclusions. IBD patients are more susceptible to CDI at a younger age and often lack traditional risk factors. IBD patients with at least one CDI were more likely to require biologic therapy and had greater rates of extraintestinal manifestations.

scholarly journals Antibiotic Prescribing for Dental Procedures in Community-Associated Clostridium difficile cases, Minnesota, 2009–2015

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S1-S1 ◽  
Author(s):  
Maria Bye ◽  
Tory Whitten ◽  
Stacy Holzbauer
Keyword(s):  
Risk Factors ◽  
Clostridium Difficile ◽  
Medical Record ◽  
Significant Risk ◽  
Healthcare Facility ◽  
Antibiotic Use ◽  
Antibiotic Prescribing ◽  
Emerging Infections ◽  
Active Population ◽  
Dental Procedures

Abstract Background Clostridium difficile infections (CDIs) are the leading cause of healthcare-associated diarrhea. Two of the most significant risk factors for CDI are antibiotic use and healthcare exposure. Dentists write approximately 10% of all outpatient prescriptions in the USA; however, limited data are available regarding dental prescribing’s impact on CDI. We described characteristics of community-associated (CA) CDI cases following antibiotics for dental procedures. Methods The Minnesota Department of Health (MDH) performs active population- and laboratory-based surveillance for CDI as part of the CDC’s Emerging Infections Program (EIP). A case was defined as a positive C. difficile toxin or molecular assay on a stool specimen from a person &gt;1 years old without a positive test in the prior 8 weeks, living in one of the five EIP catchment counties. Cases were classified as CA if stool was collected ≤3 days of admission or as an outpatient, with no overnight stay in a healthcare facility in the past 12 weeks. Medical records were reviewed and interviews performed to assess CDI risk factors and potential exposures. Differences in antibiotic prescribing and documentation among CA CDI cases receiving dental procedures were explored. Results During 2009–2015, 2176 presumptive CA CDI cases were reported to MDH; 1626 (75%) were confirmed as CA and interviewed. In total, 926 (57%) were prescribed antibiotics and 136 (15%) for dental procedures. Cases prescribed antibiotics for dental procedures were significantly older (median age: 57 vs. 45 years, P &lt; 0.001), more likely to be prescribed clindamycin (50% vs. 10%, P &lt; 0.001), and less likely to be prescribed fluoroquinolones (6% vs. 19%, P &lt; 0.001) and cephalosporins (7% vs. 30%, P &lt; 0.001) than those prescribed antibiotics for other indications. Among cases who received antibiotics for a dental procedure, 31 (23%) reported antibiotics on interview which were also documented in the medical record and 46 (34%) reported antibiotics for any reason on interview without documentation in the medical record. Conclusion Dental antibiotic prescribing rates are likely underestimated. Stewardship programs should address dental prescribing and alert dentists to CDI subsequent to antibiotics prescribed for dental procedures. Disclosures All authors: No reported disclosures.

Risk Factors for the Development of Clostridium difficile-Associated Diarrhea During a Hospital Outbreak

1991 ◽  
Vol 12 (6) ◽  
pp. 345-348 ◽  
Author(s):  
Alain Thibault ◽  
Mark A. Miller ◽  
Christina Gaese
Keyword(s):  
Risk Factors ◽  
Clostridium Difficile ◽  
Systemic Disease ◽  
Gastrointestinal Surgery ◽  
Significant Risk ◽  
Antibiotic Use ◽  
Surgical Patients ◽  
Convenience Sample ◽  
Significant Difference ◽  
Clostridium Difficile Associated Diarrhea

AbstractObjective:To evaluate the risk factors associated with a nosocomial outbreak of Clostridium difficile-associated diarrhea.Design:Case-control study with two control groups.Setting:University-affiliated urban hospital.Patients:A convenience sample of 26 patients was chosen out of a total of 78 hospitalized patients with C difficile-associated diarrhea, defined as the presence of diarrhea and a positive C difficile cytotoxin assay or stool culture. Twenty-six controls were matched for age, gender, ward, and date of admission; 18 additional controls were matched to surgical patients for date and ward of admission, as well as for the type of surgical procedure performed.Results:Significant risk factors for the development of C difficile-associated diarrhea were gastrointestinal surgery (exposure odds ratio [EOR] = 7.9, p= .004, 95% confidence interval [CI]= 1.9, 35), use of neomycin (EOR= 15.6, p=.012, 95% CI=1.7, 92), clindamycin (EOR=15.6, p=.005, 95% CI=1.7, 92), metronidazole (EOR=5.7,p=.02,95%CI= 1.4, 25), and excess antibiotic use (mean number of antibiotics = 4.2 versus 1.4, p<.00005). The presence of systemic disease and the use of antacids or immunosuppressive drugs were similar in cases and controls. In surgical patients, no specific antibiotic could be linked to C difficile-associated diarrhea because of uniform perioperative antibiotic use. There was a significant difference in the number of antibiotics administered to cases and controls (mean = 3.1 versus 1.9, p< .005).Conclusions:The results suggest that control of nosocomial C difficile-associated diarrhea may be attained by minimizing the administration of antibiotics, avoidance of high-risk antibiotics, and having a high index of suspicion of C difficile-associated diarrhea in patients who develop diarrhea after gastrointestinal surgery. Perioperative administration of metronidazole, when given with other antibiotics, failed to protect against the development of C difficile-associated diarrhea.

scholarly journals Risk factors for Clostridium difficile infection in C. difficile colonized ICU patients

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S403-S403
Author(s):  
Yuan Zhou ◽  
Larissa Lewis ◽  
Michelle McIntosh ◽  
Ferric C Fang ◽  
Ronald Pergamit ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clostridium Difficile ◽  
Disease Transmission ◽  
Significant Risk ◽  
Retrospective Chart Review ◽  
Signs And Symptoms ◽  
Significant Risk Factor ◽  
Antibiotic Use ◽  
Research Support ◽  
Icu Patients

Abstract Background Clostridium difficile is a major cause of healthcare-associated infections leading to significant morbidity and mortality; however, data-driven interventions to decrease C. difficile infections (CDI) are lacking due to an incomplete understanding of disease transmission and risk factors. Asymptomatic C. difficile carriers may be an important source of nosocomial transmission and disease but few studies have examined colonized patients who later develop CDI. We describe risk factors for the development of CDI in a critical care population screened for C. difficile colonization. Methods All patients admitted to our medical or trauma ICUs were screened for toxigenic C. difficile by PCR via rectal swab. Colonized patients were placed in contact enteric precautions for their entire hospitalization and monitored for signs and symptoms of CDI. Retrospective chart review assessed risk factors associated with development of CDI. Results 868 rectal swabs were collected from 4/01/16 to 10/31/16. 40 patients were colonized with C. difficile on ICU admission and 20 developed symptomatic CDI (Table 1). Risk factors for CDI in colonized patients include enteral feeding and exposure to antibiotics (Table 2). Conclusion 50% of C. difficile colonized ICU patients progressed to symptomatic CDI during their hospitalization. Antibiotic use was a significant risk factor for CDI. C. difficile carriers may be a particularly vulnerable population for CDI, warranting further investigation for early identification of colonized patients and strategies for infection prevention. Disclosures F. C. Fang, BioFire: Collaborator, Consultant and Scientific Advisor, Consulting fee, Research support and Speaker honorarium; Cepheid: Collaborator, Consultant and Scientific Advisor, Consulting fee, Educational grant, Research support and Speaker honorarium

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