The combined use of proton pump inhibitors and antibiotics as risk factors for Clostridium difficile infection

Kassavin, Daniel S.; Pham, David V.; Pascarella, L; Kuo, Yen-Hong; Goldfarb, Michael A.

doi:10.1071/hi12039

Cited by 4 publications

(1 citation statement)

References 14 publications

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“…Additionally, unavailability of information on prescription of antibiotics and proton pump inhibitors, which have been linked to increasing colonisation pressure of some pathogens, may likewise result in unobserved confounding. 44 45 However, as we have controlled for events where a patient Original research may be given antibiotics (procedure count and ICU admission), there is little rationale for a confounding relationship between antibiotic prescription, intrahospital transfers and HAIs. EHR information also lacks staffing levels, staff movement or casual patient movement which may be implicated in infection spread.…”

Section: Discussionmentioning

confidence: 99%

Association between intrahospital transfer and hospital-acquired infection in the elderly: a retrospective case–control study in a UK hospital network

Expert

Honeyford

et al. 2021

BMJ Qual Saf

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BackgroundIntrahospital transfers have become more common as hospital staff balance patient needs with bed availability. However, this may leave patients more vulnerable to potential pathogen transmission routes via increased exposure to contaminated surfaces and contacts with individuals.ObjectiveThis study aimed to quantify the association between the number of intrahospital transfers undergone during a hospital spell and the development of a hospital-acquired infection (HAI).MethodsA retrospective case–control study was conducted using data extracted from electronic health records and microbiology cultures of non-elective, medical admissions to a large urban hospital network which consists of three hospital sites between 2015 and 2018 (n=24 240). As elderly patients comprise a large proportion of hospital users and are a high-risk population for HAIs, the analysis focused on those aged 65 years or over. Logistic regression was conducted to obtain the OR for developing an HAI as a function of intrahospital transfers until onset of HAI for cases, or hospital discharge for controls, while controlling for age, gender, time at risk, Elixhauser comorbidities, hospital site of admission, specialty of the dominant healthcare professional providing care, intensive care admission, total number of procedures and discharge destination.ResultsOf the 24 240 spells, 2877 cases were included in the analysis. 72.2% of spells contained at least one intrahospital transfer. On multivariable analysis, each additional intrahospital transfer increased the odds of acquiring an HAI by 9% (OR=1.09; 95% CI 1.05 to 1.13).ConclusionIntrahospital transfers are associated with increased odds of developing an HAI. Strategies for minimising intrahospital transfers should be considered, and further research is needed to identify unnecessary transfers. Their reduction may diminish spread of contagious pathogens in the hospital environment.

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Section: Discussionmentioning

confidence: 99%