Journal article
Risk for Clostridioides difficile Infection Among Hospitalized Patients Associated With Multiple Healthcare Exposures Prior to Admission
The Journal of infectious diseases, Vol.224(4), pp.684-694
08/16/2021
DOI: 10.1093/infdis/jiaa773
PMCID: PMC8366437
PMID: 33340038
Abstract
Abstract
Background
Clostridioides difficile infection (CDI) is a common healthcare-associated infection and is often used as an indicator of hospital safety or quality. However, healthcare exposures occurring prior to hospitalization may increase risk for CDI. We conducted a case-control study comparing hospitalized patients with and without CDI to determine if healthcare exposures prior to hospitalization (ie, clinic visits, antibiotics, family members with CDI) were associated with increased risk for hospital-onset CDI, and how risk varied with time between exposure and hospitalization.
Methods
Records were collected from a large insurance-claims database from 2001 to 2017 for hospitalized adult patients. Prior healthcare exposures were identified using inpatient, outpatient, emergency department, and prescription drug claims; results were compared between various CDI case definitions.
Results
Hospitalized patients with CDI had significantly more frequent healthcare exposures prior to admission. Healthcare visits, antibiotic use, and family exposures were associated with greater likelihood of CDI during hospitalization. The degree of association diminished with time between exposure and hospitalization. Results were consistent across CDI case definitions.
Conclusions
Many different prior healthcare exposures appear to increase risk for CDI presenting during hospitalization. Moreover, patients with CDI typically have multiple exposures prior to admission, confounding the ability to attribute cases to a particular stay.
This retrospective case-control study evaluated exposures prior to hospital admission associated with risk for Clostridioides difficile infection (CDI). Multiple healthcare exposures, including prior hospitalization, emergency department visits, outpatient care, long-term care, and antibiotics, were associated with increased risk for CDI during a hospital stay.
Details
- Title: Subtitle
- Risk for Clostridioides difficile Infection Among Hospitalized Patients Associated With Multiple Healthcare Exposures Prior to Admission
- Creators
- Aaron C Miller - Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa, USADaniel K Sewell - Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, Iowa, USAAlberto M Segre - Department of Computer Science, University of Iowa, Iowa City, Iowa, USASriram V Pemmaraju - Department of Computer Science, University of Iowa, Iowa City, Iowa, USAPhilip M Polgreen - Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa, USACenters for Disease Control and Prevention Modeling Infectious Diseases in Healthcare Network (MInD-Healthcare)
- Resource Type
- Journal article
- Publication Details
- The Journal of infectious diseases, Vol.224(4), pp.684-694
- DOI
- 10.1093/infdis/jiaa773
- PMID
- 33340038
- PMCID
- PMC8366437
- NLM abbreviation
- J Infect Dis
- ISSN
- 0022-1899
- eISSN
- 1537-6613
- Publisher
- Oxford University Press
- Grant note
- DOI: 10.13039/100000030, name: Centers for Disease Control and Prevention, award: U01CK000531; DOI: 10.13039/100000002, name: National Institutes of Health, award: UL1TR002537
- Language
- English
- Date published
- 08/16/2021
- Academic Unit
- Infectious Diseases; Epidemiology; Biostatistics; Nursing; Fraternal Order of Eagles Diabetes Research Center; Injury Prevention Research Center; Computer Science; Public Policy Center (Archive); Internal Medicine
- Record Identifier
- 9984214709502771
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