Risk factors for Clostridium difficile infection in hospitalized patients with community-acquired pneumonia - 10/06/16
, Ahsan R. Akram b , Aran Singanayagam c , Mark H. Wilcox d, e , Adam T. Hill b, e Summary |
Objectives |
Clostridium difficile infection (CDI) is strongly associated with anti-biotic treatment, and community-acquired pneumonia (CAP) is the leading indication for anti-biotic prescription in hospitals. This study assessed the incidence of and risk factors for CDI in a cohort of patients hospitalized with CAP.
Methods |
We analysed data from a prospective, observational cohort of patients with CAP in Edinburgh, UK. Patients with diarrhoea were systematically screened for CDI, and risk factors were determined through time-dependent survival analysis.
Results |
Overall, 1883 patients with CAP were included, 365 developed diarrhoea and 61 had laboratory-confirmed CDI. The risk factors for CDI were: age (hazard ratio [HR], 1.06 per year; 95% confidence interval [CI], 1.03–1.08), total number of antibiotic classes received (HR, 3.01 per class; 95% CI, 2.32–3.91), duration of antibiotic therapy (HR, 1.09 per day; 95% CI, 1.00–1.19 and hospitalization status (HR, 13.1; 95% CI, 6.0–28.7). Antibiotic class was not an independent predictor of CDI when adjusted for these risk factors (P > 0.05 by interaction testing).
Conclusions |
These data suggest that reducing the overall antibiotic burden, duration of antibiotic treatment and duration of hospital stay may reduce the incidence of CDI in patients with CAP.
Le texte complet de cet article est disponible en PDF.Highlights |
• | We assessed risk factors for Clostridium difficile infection (CDI) in patients with CAP. |
• | CDI risk factors included age, number of antibiotics received, and hospitalization status. |
• | Length of antibiotic therapy was also a modifiable risk factor. |
• | By contrast, antibiotic class was not an independent predictor of CDI. |
• | Reducing antibiotic burden, duration of treatment and length of hospital stay may reduce CDI in CAP. |
Keywords : Antibiotics, Healthcare-associated infections, Clostridium difficile, Macrolides, Pneumonia
Plan
Vol 73 - N° 1
P. 45-53 - juillet 2016 Retour au numéro
Article précédent
- Seroprevalence of pertussis among adults in China where whole cell vaccines have been used for 50 years
- Zhiyun Chen, Jing Zhang, Lina Cao, Nan Zhang, Junping Zhu, Guoling Ping, Jianhong Zhao, Shuming Li, Qiushui He
- Host immune responses to antigens derived from a predominant strain of Mycobacterium tuberculosis
- Yun-Gyoung Hur, Wou Young Chung, Ahreum Kim, Young Sun Kim, Hyon-Suk Kim, Sun-Hee Jang, Yeun Kim, Hyeyoung Lee, Kwang Joo Park, Sang-Nae Cho
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?