Journal article
Predictors of Clostridium difficile infection and predictive impact of probiotic use in a diverse hospital-wide cohort
American journal of infection control, Vol.47(1), pp.2-8
01/2019
DOI: 10.1016/j.ajic.2018.07.014
PMCID: PMC6321775
PMID: 30205907
Abstract
•Clostridium difficile infection (CDI) was most frequently diagnosed in the emergency department.•Exposures to high-risk antibiotics, statins, and probiotics were predictive of CDI.•Probiotics did not appear to attenuate the odds of CDI in patients on antibiotics.•Some antibiotics appeared to attenuate the odds of CDI in patients on probiotics.•Bacterial probiotics were associated with higher odds of CDI than fungal probiotics.
Hospital-based predictive models for Clostridium difficile infection (CDI) may aid with surveillance efforts.
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.
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.
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.
Details
- Title: Subtitle
- Predictors of Clostridium difficile infection and predictive impact of probiotic use in a diverse hospital-wide cohort
- Creators
- Martha L Carvour - Division of Epidemiology, Biostatistics, and Preventive Medicine, Department of Internal Medicine, University of New Mexico, Albuquerque, NMShane L Wilder - University of New Mexico School of Medicine, Albuquerque, NMKeenan L Ryan - Department of Pharmacy, University of New Mexico Hospital, Albuquerque, NMCarla Walraven - Department of Pharmacy, University of New Mexico Hospital, Albuquerque, NMFares Qeadan - Division of Epidemiology, Biostatistics, and Preventive Medicine, Department of Internal Medicine, University of New Mexico, Albuquerque, NMMeghan Brett - Division of Infectious Diseases, Department of Internal Medicine, University of New Mexico, Albuquerque, NMKimberly Page - Division of Epidemiology, Biostatistics, and Preventive Medicine, Department of Internal Medicine, University of New Mexico, Albuquerque, NM
- Resource Type
- Journal article
- Publication Details
- American journal of infection control, Vol.47(1), pp.2-8
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.ajic.2018.07.014
- PMID
- 30205907
- PMCID
- PMC6321775
- ISSN
- 0196-6553
- eISSN
- 1527-3296
- Language
- English
- Date published
- 01/2019
- Academic Unit
- Infectious Diseases; Epidemiology; Fraternal Order of Eagles Diabetes Research Center; Internal Medicine
- Record Identifier
- 9984094491102771
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