Risk factors for Clostridioides difficile infection in hospitalized patients and associated mortality in Japan: a multi-centre prospective cohort study

Honda, Hitoshi; Kato, Hiroo; Olsen, Margaret A.; Reske, Kimberly A.; Senoh, Mitsutoshi; Fukuda, Tadashi; Tagashira, Yasuaki; Mahé, Cédric; Dubberke, Erik R.; Horiuchi, Hiroko; Chiba, Hiroshi; Suzuki, Daisuke; Hosokawa, Naoto; Kitazono, Hidetaka; Norisue, Yasuhiro; Kume, Hisashi; Môri, N.; Morikawa, H.; Kashiwagura, Saeko; Higuchi, Akiko; Nakamura, Makoto; Saori, Ishiguro; Morita, Sayuri; Ishikawa, Hideaki; Watanabe, Takuya; Kojima, Katsuyuki; Izumi, Yokomaku; Bando, Tatsuya; Kayoko, Toimoto; Moriya, Kyoji; Kasahara, Kei; Kitada, Shuichi; Ogawa, Jun; Saito, Haruko; Tominaga, Harumi; Shimizu, Yosuke; Masumoto, Fumi; Tadera, Kayoko; Yoshida, Junichi; Kikuchi, Tetsuya; Yoshikawa, Ichiro; Honda, Masahisa; Kuniko, Yokote; Toyokawa, Takao; Miyazato, Hiroko; Nakama, Mika

doi:10.1016/j.jhin.2019.09.012

Cited by 5 publications

(4 citation statements)

References 29 publications

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“…Also a recent study showing that prior use of antibiotics is the main factor for the presence of infection healthcare-associated endocarditis [23]. In addition, some studies did not clarify the relationship between hospital infection and antibiotics exposure [13][14][15]. Disagreement in the ndings may be due to differences in type of HAIs, adjusted covariates, patient population, and confounding by determination of antibiotic exposure time.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, antibiotic resistance has drawn attention from infectious diseases specialists, the Centers for Disease Control and Prevention, the World Health Organization, and U.S. and European governments [10][11][12]. The major risk factors associated with HAIs were low albumin, tracheostomy, prior hospital stay, central venous catheter insertion, urinary system disease, high blood glucose are associated, and intensive care unit (ICU) admission [13][14][15]. In addition, antibiotic exposure has been considered a risk factor for HAIs in previous studies [11,16,17].…”

Section: Introductionmentioning

confidence: 99%

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Combined Use of Antibiotics as a Risk Factor for Health Care–Associated Infections: A Case-Control Study

Zhang¹,

Li²

2020

Preprint

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BackgroundAntibiotics are among the most frequently prescribed medications. Many studies suggest an increased risk of health care–associated infections (HAIs) among antibiotic users. However，most related studies have focused only on a single type of HAIs, but considering the complexity and extent of the subject, it is necessary to conduct extensive research. We conducted a case-control study to determine the association between antibiotic combination therapy and risk of HAIs. MethodsRetrospective case-control study in a teaching hospital in Northwest China. Cases of 216 patients were diagnosed as HAIs during hospitalization between January 2019 and December 2019. Use antibiotics on admission and before the occurrence of HAIs were compared with 428 patients without HAIs during the same period, and matched by department.ResultsNinety-one of 216 health care–associated infections, 157 of 428 Patients without health care–associated infections prescribed antibiotics on admission and before the occurrence of HAIs. After multi-variable analysis, Compared with patients without HAIs, the OR for antibiotics combination exposure in cases was 5.43 [95% confidence interval (CI) 2.62-11.24], and the OR for antibiotics exposure in cases was 0.23 (95% CI 0.12-0.43).ConclusionsCombined use of antibiotics increases the risk of HAIs. In addition, Use of antibiotics before the diagnosis of HAIs is conducted associated with HAIs, and is the main protective factor.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Combined Use of Antibiotics as a Risk Factor for Health Care–Associated Infections: A Case-Control Study

Zhang¹,

Li²

2020

Preprint

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“… 4 , 5 Patients in hospital for prolonged stays have a greater risk of hospital-acquired C. difficile infection. 16 Previous TCdD was the historical factor having the strongest association with current TCdD risk. 4 Antibiotic 4 – 7 and proton pump inhibitor 4 , 5 , 10 exposure consistently increased TCdD risk, while exposure to histamine-2 receptor antagonists 11 and steroids 12 has also been associated with increased risk.…”

Section: Introductionmentioning

confidence: 88%

“…In addition to these 15 covariates, we identified 2 other covariates that we thought might be associated with TCdD (eosinophil count and hospitalization day of sampling) based on personal experience and cohort studies. 15 , 16 …”

Section: Methodsmentioning

confidence: 99%

Derivation and internal validation of the multivariate toxigenic C. difficile diarrhea model and risk score for emergency room and hospitalized patients with diarrhea

Davies,

Zhang,

et al. 2024

ASHE

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Background: Many factors have been associated with the risk of toxigenic C. difficile diarrhea (TCdD). This study derived and internally validated a multivariate model for estimating the risk of TCdD in patients with diarrhea using readily available clinical factors. Methods: A random sample of 3,050 symptomatic emergency department or hospitalized patients undergoing testing for toxigenic C. difficile at a single teaching hospital between 2014 and 2018 was created. Unformed stool samples positive for both glutamate dehydrogenase antigen by enzyme immunoassay and tcdB gene by polymerase chain reaction were classified as TCdD positive. The TCdD Model was created using logistic regression and was modified to the TCdD Risk Score to facilitate its use. Results: 8.1% of patients were TCdD positive. TCdD risk increased with abdominal pain (adjusted odds ratio 1.3; 95% CI, 1.0–1.8), previous C. difficile diarrhea (2.5, 1.1–6.1), and prior antibiotic exposure, especially when sampled in the emergency department (4.2, 2.5–7.0) versus the hospital (1.7, 1.3–2.3). TCdD risk also increased when testing occurred earlier during the hospitalization encounter, when age and white cell count increased concurrently, and with decreased eosinophil count. In internal validation, the TCdD Model had moderate discrimination (optimism-corrected C-statistic 0.65, 0.62–0.68) and good calibration (optimism-corrected Integrated Calibration Index [ICI] 0.017, 0.001–0.022). Performance decreased slightly for the TCdD Risk Score (C-statistic 0.63, 0.62–0.63; ICI 0.038, 0.004–0.038). Conclusions: TCdD risk can be predicted using readily available clinical risk factors with modest accuracy.

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Gastrointestinal infection

Shaban

Mitchell

Russo

et al. 2021

Epidemiology of Healthcare-Associated Infections in Australia

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Risk factors for Clostridioides difficile infection in hospitalized patients and associated mortality in Japan: a multi-centre prospective cohort study

Cited by 5 publications

References 29 publications

Combined Use of Antibiotics as a Risk Factor for Health Care–Associated Infections: A Case-Control Study

Combined Use of Antibiotics as a Risk Factor for Health Care–Associated Infections: A Case-Control Study

Derivation and internal validation of the multivariate toxigenic C. difficile diarrhea model and risk score for emergency room and hospitalized patients with diarrhea

Gastrointestinal infection

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