<i>Clostridium Difficile</i>
            Infection in Older Adults

Jump, Robin L.P.

doi:10.2217/ahe.13.37

Cited by 70 publications

(47 citation statements)

References 90 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Advance age is an independent RF for CDI in many studies [5, 9, 10]. RFs specific to older adults are frequent interactions with healthcare systems and age-related changes in physiology, including immune senescence and changes of the gut microbiome [13]. In our study majority of CDI occurred in patients older than 40 years and half in patients older than 65 years.…”

Section: Discussionmentioning

confidence: 54%

Risk factors for Clostridium difficile infection in surgical patients hospitalized in a tertiary hospital in Belgrade, Serbia: a case–control study

Šuljagić

Miljković

Starčević

et al. 2017

Antimicrob Resist Infect Control

View full text Add to dashboard Cite

BackgroundThe objective of this study was to investigate independent risk factors (RFs) connected with healthcare-associated (HA) Clostridium difficile infection (CDI) in surgical patients, its frequency per surgical wards and in-hospital-mortality at a single hospital.MethodsRisk factors for the infection were prospectively assessed among surgical patients with laboratory confirmed HA CDI and compared with a control group without HA CDI.ResultsThe overall incidence rate of HA CDI was 2.6 per 10000 patient-days. Significant independent RFs for HA CDI were the use of carbapenems (P = 0.007, OR: 10.62, 95% CI: 1.93–58.4), the admission to intensive care unit (P = 0.004, OR:3.00, 95% CI:1.41–6.40), and the administration of 3rd generation cephalosporins (P = 0.014, OR:2.27, 95% CI:1.18–4.39). Patients with HA CDI had significantly higher in–hospital mortality compared to controls (P: 0.007; OR: 8.95; 95% CI: 1.84–43.43).ConclusionsCDI is an important HA infection in population of surgical patients and this study emphasizes the importance of the wise use of antibiotics, and other infection control strategies in order to prevent HA CDI, and to decrease the incidence and in-hospital mortality rate.

show abstract

Section: Discussionmentioning

confidence: 54%

Risk factors for Clostridium difficile infection in surgical patients hospitalized in a tertiary hospital in Belgrade, Serbia: a case–control study

Šuljagić

Miljković

Starčević

et al. 2017

Antimicrob Resist Infect Control

View full text Add to dashboard Cite

show abstract

“…Age was considered a continuous covariate in bivariate analysis due to its previously established linear associations with CDI. 17 Candidacy for covariates in a multivariable analysis was determined by the significance of association in the bivariate approach as indicated by a p-value of less than 0.10. The linearity of association between CDI and total Elixhauser score was assessed and due to its linear association, the Elixhauser was analyzed as a continuous variable.…”

Section: Methodsmentioning

confidence: 99%

Electronically Available Comorbid Conditions for Risk Prediction of Healthcare-Associated Clostridium difficile Infection

Harris

Sbarra

Leekha

et al. 2018

Infect. Control Hosp. Epidemiol.

View full text Add to dashboard Cite

OBJECTIVE To analyze whether electronically available comorbid conditions are risk factors for Centers for Disease Control and Prevention (CDC)-defined, hospital-onset Clostridium difficile infection (CDI) after controlling for antibiotic and gastric acid suppression therapy use. PATIENTS Patients aged ≥18 years admitted to the University of Maryland Medical Center between November 7, 2015, and May 31, 2017. METHODS Comorbid conditions were assessed using the Elixhauser comorbidity index. The Elixhauser comorbidity index and the comorbid condition components were calculated using the International Classification of Disease, Tenth Revision, Clinical Modification (ICD-10-CM) codes extracted from electronic medical records. Bivariate associations between CDI and potential covariates for multivariable regression, including antibiotic use, gastric acid suppression therapy use, as well as comorbid conditions, were estimated using log binomial multivariable regression. RESULTS After controlling for antibiotic use, age, proton-pump inhibitor use, and histamine-blocker use, the Elixhauser comorbidity index was a significant risk factor for predicting CDI. There was an increased risk of 1.26 (95% CI, 1.19-1.32) of having CDI for each additional Elixhauser point added to the total Elixhauser score. CONCLUSIONS An increase in Elixhauser score is associated with CDI. Our study and other studies have shown that comorbid conditions are important risk factors for CDI. Electronically available comorbid conditions and scores like the Elixhauser index should be considered for risk-adjustment of CDC CDI rates. Infect Control Hosp Epidemiol 2018;39:297-301.

show abstract

“…[113] It is a well-known fact that the gastric pH in elderly patients is lower compared to young individuals. [114] This explains why advanced age is one of the most notable risk factors (along with systemic antibiotics and acid suppression medications) for developing C. difficile infection.…”

Section: Intestinal Microbiomementioning

confidence: 99%

The Gastric and Intestinal Microbiome: Role of Proton Pump Inhibitors

Minalyan

Gabrielyan

Scott

et al. 2017

Curr Gastroenterol Rep

View full text Add to dashboard Cite

Purpose of review The discovery of Helicobacter pylori and other organisms colonizing the stomach and the intestines has shed some light on the importance of microbiome in maintaining overall health and developing pathological conditions when alterations in biodiversity are present. The gastric acidity plays a crucial role in filtering out bacteria and preventing development of enteric infections. In this article, we discuss the physiology of gastric acid secretion and bacterial contribution to the composition of gastric and intestinal barriers and review the current literature on the role of proton pump inhibitors (PPIs) in the microbial biodiversity of the gastrointestinal tract. Recent findings Culture-independent techniques, such as 16S rRNA sequencing, have revolutionized our understanding of the microbial biodiversity in the gastrointestinal tract. Luminal and mucosa-associated microbial populations are not identical. Streptococcus is overrepresented in the biopsies of patients with antral gastritis and may also be responsible for the development of peptic ulcer disease. The use of PPIs favors relative streptococcal abundance irrespective of H. pylori status and may explain the persistence of dyspeptic symptoms in patients on PPI therapy. Increased risk of enteric infections has also been seen in patients taking PPIs. The overuse of PPIs leads to significant shift of the gastrointestinal microbiome towards a less healthy state. Summary With the advent of PPIs, many studies have demonstrated the significant changes in the microbial composition of both gastric and intestinal microbiota. Although they are considered relatively safe over-the-counter medications, PPIs in many cases are over- and even inappropriately used. Future studies assessing the safety of PPIs and their role in the development of microbiome changes should be encouraged.

show abstract

Clostridium Difficile Infection in Older Adults

Cited by 70 publications

References 90 publications

Risk factors for Clostridium difficile infection in surgical patients hospitalized in a tertiary hospital in Belgrade, Serbia: a case–control study

Risk factors for Clostridium difficile infection in surgical patients hospitalized in a tertiary hospital in Belgrade, Serbia: a case–control study

Electronically Available Comorbid Conditions for Risk Prediction of Healthcare-Associated Clostridium difficile Infection

The Gastric and Intestinal Microbiome: Role of Proton Pump Inhibitors

Contact Info

Product

Resources

About