IBD: A Growing and Vulnerable Cohort of Hospitalized Patients with Clostridium difficile Infection

2017 ◽  
Vol 83 (6) ◽  
pp. 605-609 ◽  
Author(s):  
Allan Mabardy ◽  
Justin Mccarty ◽  
Alan Hackford ◽  
Haisar Dao
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Total Colectomy ◽  
The United States ◽  
Primary Diagnosis ◽  
Hospitalized Patients ◽  
Nationwide Inpatient Sample Database ◽  
Rising Incidence ◽  
Inflammatory Bowel ◽  
National Trends

The most recent nationwide data show a rising incidence of Clostridium difficile infection in hospitalized patients with ulcerative colitis (UC). We describe recent national trends with regard to incidence, mortality, and the rate of total colectomy. The Nationwide Inpatient Sample database identified patients admitted to hospitals in the United States with diagnoses of C. difficile and inflammatory bowel disease (IBD) during the study years 2007 to 2013. We analyzed incidence of C. difficile, mortality, and colectomy rates. From 2007 to 2013, incidence of patients with IBD admitted with the primary diagnosis of C. difficile rose faster than the non-IBD population (1.24% to 2.14% vs 0.26% to 0.30%, P < 0.0001) and specifically in the UC population rose from 2.36 to 3.48 per cent (P < 0.001). The mortality of non-IBD patients with C. difficile decreased 47 per cent (3.76% to 1.99%, P = 0.003), whereas mortality of IBD patients with C. difficile decreased 54 per cent (6.08% to 2.79%, P = 0.003). For UC patients with primary diagnosis C. difficile, the percentage undergoing total colectomy decreased by 38 per cent (2.47% vs 1.51%, P = 0.049). The incidence of C. difficile continues to rise in the both the IBD and non-IBD population. Our study shows decreasing mortality for IBD and non-IBD patients with C. difficile but a greater decrease in mortality for IBD patients.

scholarly journals The Use of Probiotics in the Prevention of Clostridium Difficile Infection

2016 ◽  
Author(s):  
Lindsay Mook
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Healthcare Providers ◽  
Hospital Setting ◽  
Retrospective Chart Review ◽  
The United States ◽  
Hospitalized Patients ◽  
Study Results ◽  
Prescribing Trends ◽  
Hospital Acquired

<p>Despite advances in the diagnosis and treatment of Clostridium difficile infection (CDI), the prevention of CDI, particularly in the inpatient hospital setting, remains a challenge. Clostridium difficile now rivals methicillin-resistant staphylococcus aureus (MRSA) as the most common pathogen to cause hospital acquired infections (HAI) in the United States. Hospitalized patients are considered to be especially high risk for CDI, and among inpatient cases, antibiotic treatment, especially with Fluoroquinolones has been an almost universal factor in the development of CDIs. One preventative measure that is incontinently used in the prevention of CDI is oral probiotics. Probiotic consumption is reported to exert a myriad of beneficial effects including enhanced immune response, balancing of colonic microbiota, treatment of diarrhea associated with travel and antibiotic therapy, control of rotavirus and clostridium difficile induced colitis. The American College of Gastroenterology recognizes the role of probiotics and included probiotics as a level B recommendation for the treatment of CDI. It has been hypothesized that the use of probiotics, as an adjunctive therapy in patients receiving antibiotics, may provide a key intervention in reducing primary CDI. The purpose of this study was to conduct a retrospective chart review to explore healthcare providers prescribing trends regarding Fluoroquinolone antibiotics and adjunctive probiotics in patients with hospital acquired CDI. The Synergy model was used to guide the study. Results indicated that probiotics are not frequently prescribed for hospitalized patients on Fluoroquinolones and when they are it is with inconsistency. Additional research is recommended to further assess the use of probiotics in conjunction with other classes of commonly used antibiotics; this study solely looked at Fluoroquinolones.</p>

scholarly journals Increasing Economic Burden of Inpatient Clostridium difficile Infection in the United States: National Trends in Epidemiology, Outcomes, and Cost of Care from 2000 to 2014

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S392-S392 ◽  
Author(s):  
Ru Min Lee ◽  
Neil O Fishman
Keyword(s):  
United States ◽  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Economic Burden ◽  
The United States ◽  
Primary Diagnosis ◽  
Cost Of Care ◽  
Hospital Charges ◽  
Inpatient Mortality ◽  
The Us

Abstract Background There is limited data addressing the epidemiology, costs, and outcomes of Clostridium difficile infection (CD) in hospitalized patients in the United States (U.S.). This study aims to estimate the characteristics, outcomes, and economic burden of patients hospitalized for CD in the US. Methods The Nationwide Inpatient Sample (NIS) database was used to obtain data from 2000–2014. The NIS contains data from over 7 million hospitalizations in the US per year, generalizable to the American population. The NIS was queried for ICD-9 codes for either a primary or secondary diagnosis of CD (008.45). Information for demographic data, length of stay (LOS), mortality, and hospital charges was evaluated. Results There were 1,256,783 total discharges from 2000–2014 with CD as the primary diagnosis and 4,204,338 total discharges during the same period with CD listed as any diagnosis. The number of hospitalizations with CD as primary diagnosis increased from 31,782 in 2000 to 107,760 in 2014. The number of hospitalizations with CD listed as any diagnosis increased from 134,518 to 361,945. Mean LOS decreased from 6.8 to 5.8 days and mean charges per hospitalization increased from $15,810 to $35,898 during the same time period. Aggregate charges increased from $0.51 billion to $3.87 billion annually. Inpatient mortality of CD hospitalizations decreased from a 4.03% in 2005 to 1.67% in 2014. Approximately 42% of those admitted for CD were male and 58% were female. Conclusion This study demonstrates that the number of hospitalizations for CD has increased by 339% from 2000 to 2014. Inpatient mortality of CD has decreased, likely from earlier recognition and treatment of CD. The direct cost of admissions with CD as primary diagnosis is nearly $4 billion per year. Our findings affirm that CD infection is an epidemic that remains a significant source of morbidity and mortality with substantial hospitalization and cost burden. This data can be used to support a return on investment for intervention strategies to prevent CD transmission and for new therapies. Disclosures All authors: No reported disclosures.

scholarly journals Clostridium difficile infection in hospitalized patients with inflammatory bowel disease

Medicine ◽  
2018 ◽  
Vol 97 (5) ◽  
pp. e9772 ◽  
Author(s):  
Nitsan Maharshak ◽  
Idan Barzilay ◽  
Hasya Zinger ◽  
Keren Hod ◽  
Iris Dotan
Keyword(s):  
Inflammatory Bowel Disease ◽  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Bowel Disease ◽  
Hospitalized Patients ◽  
Inflammatory Bowel
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