Epidemiological features of Clostridium difficile infection among inpatients at Hamad General Hospital in the state of Qatar, 2006–2009

Khan, Fahmi Yousef; Abukhattab, Mohammed; Deshmukh, Anand; Baager, Khalid; Alaini, Ahmed; Siddique, Mashhood A.; Mohamed, Shehab; Ali, Mir Inzamam; bedawi, Mamoon M. Al; Naser, Mohamed S.

doi:10.1016/j.tmaid.2012.06.004

Cited by 14 publications

(11 citation statements)

References 36 publications

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“… Characteristics of included studies addressing risk factors for mortality considered alone [21]–[24], [53], [55]–[57], [59]–[63], [72]–[74], [89], [90], [92], [94], [99]–[101]. …”

Section: Supporting Informationmentioning

confidence: 99%

Risk Factors for Recurrence, Complications and Mortality in Clostridium difficile Infection: A Systematic Review

et al. 2014

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Background Clostridium difficile infection (CDI) can lead to complications, recurrence, and death. Numerous studies have assessed risk factors for these unfavourable outcomes, but systematic reviews or meta-analyses published so far were limited in scope or in quality.MethodsA systematic review was completed according to PRISMA guidelines. An electronic search in five databases was performed. Studies published until October 2013 were included if risk factors for at least one CDI outcome were assessed with multivariate analyses.Results68 studies were included: 24 assessed risk factors for recurrence, 18 for complicated CDI, 8 for treatment failure, and 30 for mortality. Most studies accounted for mortality in the definition of complicated CDI. Important variables were inconsistently reported, such as previous episodes and use of antibiotics. Substantial heterogeneity and methodological limitations were noted, mainly in the sample size, the definition of the outcomes and periods of follow-up, precluding a meta-analysis. Older age, use of antibiotics after diagnosis, use of proton pump inhibitors, and strain type were the most frequent risk factors for recurrence. Older age, leucocytosis, renal failure and co-morbidities were frequent risk factors for complicated CDI. When considered alone, mortality was associated with age, co-morbidities, hypo-albuminemia, leucocytosis, acute renal failure, and infection with ribotype 027.ConclusionLaboratory parameters currently used in European and American guidelines to define patients at risk of a complicated CDI are adequate. Strategies for the management of CDI should be tailored according to the age of the patient, biological markers of severity, and underlying co-morbidities.

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Section: Supporting Informationmentioning

confidence: 99%

Risk Factors for Recurrence, Complications and Mortality in Clostridium difficile Infection: A Systematic Review

et al. 2014

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“…Forty two included only hospitalized patients[9, 22–24, 28–40, 42, 43, 46, 48, 50–55, 57, 59–67, 69–71], 1 was exclusively among outpatients[47], and 8 included both groups. [25, 26, 41, 44, 45, 49, 56, 68] A total of 16 countries were represented, with China contributing the largest number of studies.…”

Section: Resultsmentioning

confidence: 99%

“…Twenty-five studies were from East Asia[9, 22, 24, 26, 28, 34–37, 39–42, 44, 52–54, 56, 58–61, 67, 70, 71], 16 from South Asia[23, 25, 27, 29, 31, 33, 43, 46, 51, 55, 62–64, 66, 68, 69] and 10 from the Middle East. [30, 32, 38, 45, 47–50, 57, 65] The mean age of included patients was 60 years (data from 24 studies) and just fewer than half the cohort were women (43%, 34 studies). From 28 studies presenting data on antibiotic use; a mean of 84% of patients had been exposed recently (range 26–100%).…”

Section: Resultsmentioning

confidence: 99%

The emergence of Clostridium difficile infection in Asia: A systematic review and meta-analysis of incidence and impact

et al. 2017

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BackgroundClostridium difficile infection (CDI) is the most common healthcare associated infection and is highly prevalent in Europe and North America. Limited data is available on the prevalence of CDI in Asia. However, secular increases in prevalence of risk factors for CDI suggest that it may be emerging as a major cause of morbidity, highlighting the urgent need for a systematic study of the prevalence of CDI in Asia.MethodsWe systematically searched PubMed/Medline and Embase for publications from Asia between 2000–16 examining prevalence of CDI. A random-effects meta-analysis was performed to calculate the pooled prevalence of CDI in Asia and to identify subgroups and regions at high risk.ResultsOur meta-analysis included 51 studies from throughout Asia including 37,663 patients at risk among whom confirmed CDI was found in 4,343 patients. The pooled proportion of confirmed CDI among all patients with diarrhea was 14.8% with a higher prevalence in East Asia (19.5%), compared with South Asia (10.5%) or the Middle East (11.1%). There were an estimated 5.3 episodes of CDI per 10,000 patient days, similar to rates reported from Europe and North America. Infections due to hypervirulent strains were rare. CDI-related mortality was 8.9%.ConclusionsIn a meta-analysis of 51 studies, we observed similar rates of CDI in Asia in comparison to Europe and North America. Increased awareness and improved surveillance of Clostridium difficile is essential to reduce incidence and morbidity.

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“…The recovery rate from CDI was reported in eight studies (Table 6) [22,26,31,32,51,54-56]. Recovery was typically dependent on treatment with antimicrobials (either metronidazole or vancomycin).…”

Section: Resultsmentioning

confidence: 99%

“…Three of the studies were judged to have low NOS quality scores due to one or all of the following reasons: unclear definitions of recovery, lack of information on how recovery was ascertained and insufficient follow up data [31,54,55]. Of the others, three were judged to be of good quality on the basis of clear definitions and the use of consistent methods of ascertaining recovery [22,26,32]. …”

Section: Resultsmentioning

confidence: 99%

Parameters for the Mathematical Modelling of Clostridium difficile Acquisition and Transmission: A Systematic Review

et al. 2013

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IntroductionMathematical modelling of Clostridium difficile infection dynamics could contribute to the optimisation of strategies for its prevention and control. The objective of this systematic review was to summarise the available literature specifically identifying the quantitative parameters required for a compartmental mathematical model of Clostridium difficile transmission.MethodsSix electronic healthcare databases were searched and all screening, data extraction and study quality assessments were undertaken in duplicate. Results were synthesised using a narrative approach.ResultsFifty-four studies met the inclusion criteria. Reproduction numbers for hospital based epidemics were described in two studies with a range from 0.55 to 7. Two studies provided consistent data on incubation periods. For 62% of cases, symptoms occurred in less than 4 weeks (3-28 days) after infection. Evidence on contact patterns was identified in four studies but with limited data reported for populating a mathematical model. Two studies, including one without clinically apparent donor-recipient pairs, provided information on serial intervals for household or ward contacts, showing transmission intervals of <1 week in ward based contacts compared to up to 2 months for household contacts. Eight studies reported recovery rates of between 75% - 100% for patients who had been treated with either metronidazole or vancomycin. Forty-nine studies gave recurrence rates of between 3% and 49% but were limited by varying definitions of recurrence. No study was found which specifically reported force of infection or net reproduction numbers. ConclusionsThere is currently scant literature overtly citing estimates of the parameters required to inform the quantitative modelling of Clostridium difficile transmission. Further high quality studies to investigate transmission parameters are required, including through review of published epidemiological studies where these quantitative estimates may not have been explicitly estimated, but that nonetheless contain the relevant data to allow their calculation. [Systematic review reference: CRD42012003081]

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Epidemiological features of Clostridium difficile infection among inpatients at Hamad General Hospital in the state of Qatar, 2006–2009

Cited by 14 publications

References 36 publications

Risk Factors for Recurrence, Complications and Mortality in Clostridium difficile Infection: A Systematic Review

Risk Factors for Recurrence, Complications and Mortality in Clostridium difficile Infection: A Systematic Review

The emergence of Clostridium difficile infection in Asia: A systematic review and meta-analysis of incidence and impact

Parameters for the Mathematical Modelling of Clostridium difficile Acquisition and Transmission: A Systematic Review

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