A time-series analysis of clostridium difficile and its seasonal association with influenza

Philip M Polgreen; Ming Yang; Lucas C Bohnett; Joseph E Cavanaugh

doi:10.1086/651095

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A time-series analysis of clostridium difficile and its seasonal association with influenza

Journal article

Open access

Peer reviewed

A time-series analysis of clostridium difficile and its seasonal association with influenza

Philip M Polgreen, Ming Yang, Lucas C Bohnett and Joseph E Cavanaugh

Infection control and hospital epidemiology, Vol.31(4), pp.382-387

04/2010

DOI: 10.1086/651095

PMCID: PMC3024857

PMID: 20175682

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https://www.ncbi.nlm.nih.gov/pmc/articles/3024857View

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Abstract

To characterize the temporal progression of the monthly incidence of Clostridium difficile infections (CDIs) and to determine whether the incidence of CDI is related to the incidence of seasonal influenza. A retrospective study of patients in the Nationwide Inpatient Sample during the period from 1998 through 2005. We identified all hospitalizations with a primary or secondary diagnosis of CDI with use of International Classification of Diseases, 9th Revision, Clinical Modification codes, and we did the same for influenza. The incidence of CDI was modeled as an autoregression about a linear trend. To investigate the association of CDI with influenza, we compared national and regional CDI and influenza series data and calculated cross-correlation functions with data that had been prewhitened (filtered to remove temporal patterns common to both series). To estimate the burden of seasonal CDI, we developed a proportional measure of seasonal CDI. Time-series analysis of the monthly number of CDI cases reveals a distinct positive linear trend and a clear pattern of seasonal variation (R2 = 0.98). The cross-correlation functions indicate that influenza activity precedes CDI activity on both a national and regional basis. The average burden of seasonal (ie, winter) CDI is 23%. The epidemiologic characteristics of CDI follow a pattern that is seasonal and associated with influenza, which is likely due to antimicrobial use during influenza seasons. Approximately 23% of average monthly CDI during the peak 3 winter months could be eliminated if CDI remained at summer levels.

International Classification of Diseases

United States - epidemiology

Enterocolitis, Pseudomembranous - epidemiology

Humans

Clostridium difficile

Hospitalization - statistics & numerical data

Influenza, Human - epidemiology

Enterocolitis, Pseudomembranous - microbiology

Influenza, Human - complications

Incidence

Enterocolitis, Pseudomembranous - complications

Time Factors

Seasons

Enterocolitis, Pseudomembranous - diagnosis

Details

Title: Subtitle: A time-series analysis of clostridium difficile and its seasonal association with influenza
Creators: Philip M Polgreen - Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa 52242, USA. philip-polgreen@uiowa.edu
Ming Yang
Lucas C Bohnett
Joseph E Cavanaugh
Resource Type: Journal article
Publication Details: Infection control and hospital epidemiology, Vol.31(4), pp.382-387
DOI: 10.1086/651095
PMID: 20175682
PMCID: PMC3024857
NLM abbreviation: Infect Control Hosp Epidemiol
ISSN: 0899-823X
eISSN: 1559-6834
Publisher: United States
Grant note: AI75089-01A1 / NIAID NIH HHS K01 AI075089-03 / NIAID NIH HHS K01 AI075089 / NIAID NIH HHS
Language: English
Date published: 04/2010
Academic Unit: Statistics and Actuarial Science; Infectious Diseases; Epidemiology; Biostatistics; Injury Prevention Research Center; Internal Medicine
Record Identifier: 9983985890702771

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