Predictors of Clostridium difficile infection and predictive impact of probiotic use in a diverse hospital-wide cohort
| Autor: | Shane L. Wilder, Fares Qeadan, Martha L. Carvour, Keenan L. Ryan, Kimberly Page, Meghan Brett, Carla Walraven |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent genetic structures Epidemiology Logistic regression Article law.invention Young Adult 03 medical and health sciences 0302 clinical medicine Risk Factors law Clinical Decision Rules Internal medicine medicine Humans 030212 general & internal medicine Aged Retrospective Studies Aged 80 and over Cross Infection 0303 health sciences 030306 microbiology business.industry Probiotics Health Policy Public Health Environmental and Occupational Health Retrospective cohort study Environmental Exposure Emergency department Odds ratio Middle Aged Clostridium difficile Intensive care unit Confidence interval Anti-Bacterial Agents Infectious Diseases Cohort Clostridium Infections Female Hydroxymethylglutaryl-CoA Reductase Inhibitors business |
| Zdroj: | American Journal of Infection Control. 47:2-8 |
| ISSN: | 0196-6553 |
| DOI: | 10.1016/j.ajic.2018.07.014 |
| Popis: | Background Hospital-based predictive models for Clostridium difficile infection (CDI) may aid with surveillance efforts. Methods A retrospective cohort of adult hospitalized patients who were tested for CDI between May 1, 2011, and August 31, 2016, was formed. Proposed clinical and sociodemographic predictors of CDI were evaluated using multivariable predictive logistic regression modeling. Results In a cohort of 5,209 patients, including 1,092 CDI cases, emergency department location (adjusted odds ratio [aOR], 1.91; 95% confidence interval [CI], 1.51, 2.41; compared with an intensive care unit reference category, which had the lowest observed odds in the study) and prior exposure to a statin (aOR, 1.26, 95% CI, 1.06, 1.51), probiotic (aOR, 1.39; 95% CI, 1.08, 1.80), or high-risk antibiotic (aOR, 1.54; 95% CI, 1.29, 1.84), such as a cephalosporin, a quinolone, or clindamycin, were independent predictors of CDI. Probiotic use did not appear to attenuate the odds of CDI in patients exposed to high-risk antibiotics, but moderate-risk antibiotics appeared to significantly attenuate the odds of CDI in patients who received probiotics. Conclusions Emergency department location, high-risk antibiotics, probiotics, and statins were independently predictive of CDI. Further exploration of the relationship between probiotics and CDI, especially in diverse patient populations, is warranted. |
| Databáze: | OpenAIRE |
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