Impact of the COVID-19 pandemic on the incidence of healthcare facility-onset Clostridioides difficile infection in hospitalized patients with sepsis: Interrupted time series analysis using Japanese Diagnosis Procedure Combination data

Endo, Koji; Mizuno, Kayoko; Takeuchi, Masato; Kawakami, Koji

doi:10.1016/j.anaerobe.2023.102693

Cited by 3 publications

(3 citation statements)

References 27 publications

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“…The remaining 20 studies included patients with sepsis with both infection and organ dysfunction (Figure 1). Of the 20 studies investigating patients with sepsis, 6 examined patients with sepsis as a whole, regardless of the site of infection and organ dysfunction 13–18 . The remaining 14 studies included only sepsis with pneumonia, perforation of the lower gastrointestinal tract, or shock 12,19–31 .…”

Section: Resultsmentioning

confidence: 99%

“…Of the 20 studies investigating patients with sepsis, 6 examined patients with sepsis as a whole, regardless of the site of infection and organ dysfunction. [13][14][15][16][17][18] The remaining 14 studies included only sepsis with pneumonia, perforation of the lower gastrointestinal tract, or shock. 12,[19][20][21][22][23][24][25][26][27][28][29][30][31] Four studies on patients with sepsis overall were based on the same cohort [13][14][15][16] (Table 1).…”

Section: R E Su Ltsmentioning

confidence: 99%

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Epidemiology of sepsis in a Japanese administrative database

Imaeda,

Oami,

Takahashi

et al. 2023

Acute Medicine & Surgery

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Sepsis is the leading cause of death worldwide. Considering regional variations in the characteristics of patients with sepsis, a better understanding of the epidemiology in Japan will lead to further development of strategies for the prevention and treatment of sepsis. To investigate the epidemiology of sepsis, we conducted a systematic literature review of PubMed between 2003 and January 2023. Among the 78 studies using a Japanese administrative database, we included 20 that defined patients with sepsis as those with an infection and organ dysfunction. The mortality rate in patients with sepsis has decreased since 2010, reaching 18% in 2017. However, the proportion of inpatients with sepsis is increasing. A study comparing short‐course (≤7 days) and long‐course (≥8 days) antibiotic administration showed lower 28‐day mortality in the short‐course group. Six studies on the treatment of patients with septic shock reported that low‐dose corticosteroids or polymyxin B hemoperfusion reduced mortality, whereas intravenous immunoglobulins had no such effect. Four studies investigating the effects of treatment in patients with sepsis‐associated disseminated intravascular coagulation demonstrated that antithrombin may reduce mortality, whereas recombinant human soluble thrombomodulin does not. A descriptive study of medical costs for patients with sepsis showed that the effective cost per survivor decreased over an 8‐year period from 2010 to 2017. Sepsis has a significant impact on public health, and is attracting attention as an ongoing issue. Further research to determine more appropriate prevention methods and treatment for sepsis should be a matter of priority.

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Section: Resultsmentioning

confidence: 99%

Section: R E Su Ltsmentioning

confidence: 99%

Epidemiology of sepsis in a Japanese administrative database

Imaeda,

Oami,

Takahashi

et al. 2023

Acute Medicine & Surgery

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“…This is still controversial, considering the report that there is no significant association between functional status and asymptomatic CDI [18] and the conflicting report that the preserved functional status rather predisposes to CDI through environmental contamination [19]. A recent Japanese study demonstrated a higher incidence of HO-CDI in both advanced age and lower BI subgroups, with a cutoff BI value of 18 (the median of participants) [20]. In the present study, a total score of 25 was set as the optimal cutoff value for BI using the Youden’s index by receiver operating characteristic curve.…”

Section: Discussionmentioning

confidence: 99%

Impact of Functional Status on Development of Clostridioides difficile Infection and Increase in Inhospital Mortality among Antibiotic Users

Watanabe,

Tsuji,

Saruta

et al. 2023

Digestion

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Introduction: Functional status is one of the surrogates of advanced age, an established risk factor for Clostridioides difficile infection (CDI). We aimed to investigate the usefulness of functional status in the clinical management of CDI. Methods: We enrolled all hospitalized adult patients receiving antibiotics from a retrospective hospital-based cohort in Japan between 2016 and 2020. Using the Barthel index (BI), which is an objective scale of functional status, we investigated the association of BI with developing CDI and its impact on inhospital mortality in patients with CDI. Results: We enrolled 17,131 patients with 100 cases of CDI. Multivariable analysis revealed that lower BI (≤25) was an independent risk factor for developing CDI (adjusted odds ratio, 4.11; 95% confidence interval, 2.62–6.46). Furthermore, a combination of BI and Charlson comorbidity index (CCI) showed an adjusted odds ratio of 36.40 (95% confidence interval, 17.30–76.60) in the highest risk group. A high-risk group according to the combination of BI and CCI was estimated to have significantly higher inhospital mortality in patients with CDI using the Kaplan-Meier method (p = 0.017). A combination of lower BI and higher CCI was an independent predictor of inhospital mortality even in the multivariable Cox regression model (adjusted hazard ratio, 3.00; 95% confidence interval, 1.01–8.88). Conclusions: Assessment of functional status, especially combined with comorbidities, was significantly associated with developing CDI and may also be useful in predicting inhospital mortality.

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Association Between Arterial Pulse Waveform Analysis and Mortality in Patients With Septic Shock: A Retrospective Cohort Study Using Japanese Diagnosis Procedure Combination Data

Endo,

Mizuno,

Yoshida

et al. 2024

J Intensive Care Med

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Purpose: Specialized pressure transducers for arterial pulse waveform analysis (S-APWA) devices are dedicated kits connected to an arterial pressure catheter that monitors hemodynamic parameters, such as cardiac output, pulse pressure variation, and stroke volume variation, less invasively. While the association between the use of S-APWA devices and clinical outcomes in perioperative patients has been previously evaluated, its assessment in patients with septic shock remains inadequate. Materials and Methods: This retrospective cohort study utilized a nationwide Diagnosis Procedure Combination database in Japan. Adult patients with septic shock admitted to the intensive care unit (ICU) with arterial pressure catheter placement on the admission day from August 2012 to February 2021 were included. Hospitalizations meeting the eligibility criteria were categorized into groups based on S-APWA device usage. The primary outcome, evaluated using Cox regression analysis, was 30-day all-cause mortality in the propensity score overlap-weighted population. Secondary outcomes included in-hospital mortality, ICU duration, and overall hospital stay. Results: Among 5130 eligible hospitalizations, 643 were in the S-APWA group and 4487 were in the conventional pressure transducer group. Cox regression analysis within the propensity score overlap-weighted population showed no significant difference in 30-day mortality (adjusted hazard ratio: 0.94; 95% confidence interval: 0.9-1.38; P = .58). Logistic regression analysis indicated no significant differences in the in-hospital mortality. While the S-APWA group had prolonged ICU stays, no significant difference in the overall hospital stay was observed according to linear regression analyses. Conclusions: Our study found no significant association between S-APWA use and 30-day mortality in patients with septic shock. These findings offer insights into optimizing monitoring systems in ICUs.

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Impact of the COVID-19 pandemic on the incidence of healthcare facility-onset Clostridioides difficile infection in hospitalized patients with sepsis: Interrupted time series analysis using Japanese Diagnosis Procedure Combination data

Cited by 3 publications

References 27 publications

Epidemiology of sepsis in a Japanese administrative database

Epidemiology of sepsis in a Japanese administrative database

Impact of Functional Status on Development of <i>Clostridioides difficile</i> Infection and Increase in Inhospital Mortality among Antibiotic Users

Association Between Arterial Pulse Waveform Analysis and Mortality in Patients With Septic Shock: A Retrospective Cohort Study Using Japanese Diagnosis Procedure Combination Data

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