Severity and frequency of community-onset Clostridium difficile infection on an Australian tertiary referral hospital campus

Clohessy, Penny; Merif, Juan; Post, Jeffrey J.

doi:10.1016/j.ijid.2014.08.009

Cited by 12 publications

(12 citation statements)

References 17 publications

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“…Our results were generally similar to published literature, where it has been reported that those with community-onset CDI have a median age of 61 years, 52% to 61% are female, and 11% die within 30 days [3, 28]. In our cohort, the median age was 69 years, 63% were female, and 12% died within 30 days.…”

Section: Discussionsupporting

confidence: 91%

“…We are uncertain about how many infected subjects we missed; however, Hirshon et al found that 4% of outpatients with diarrhea tested positive for CDI between 2002 and 2007 in the US [35]. Missing subjects who only visited physician offices for CDI could explain why we captured fewer individuals with community-onset CDI than previously reported (22% versus 29% to 58% of all CDI cases [3, 4]). However, this could also be due to regional variations.…”

Section: Discussionmentioning

confidence: 92%

“…Approximately 29% to 58% of CDI cases have symptom onset in the community or within two or three days of a hospital admission [3–6]. These cases are classified as having community-onset CDI, regardless of whether infection originated from a healthcare facility or the community [4].…”

Section: Introductionmentioning

confidence: 99%

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A population-based matched cohort study examining the mortality and costs of patients with community-onset Clostridium difficile infection identified using emergency department visits and hospital admissions

et al. 2017

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Few studies have evaluated the mortality or quantified the economic burden of community-onset Clostridium difficile infection (CDI). We estimated the attributable mortality and costs of community-onset CDI. We conducted a population-based matched cohort study. We identified incident subjects with community-onset CDI using health administrative data (emergency department visits and hospital admissions) in Ontario, Canada between January 1, 2003 and December 31, 2010. We propensity-score matched each infected subject to one uninfected subject and followed subjects in the cohort until December 31, 2011. We evaluated all-cause mortality and costs (unadjusted and adjusted for survival) from the healthcare payer perspective (2014 Canadian dollars). During our study period, we identified 7,950 infected subjects. The mean age was 63.5 years (standard deviation = 22.0), 62.7% were female, and 45.0% were very high users of the healthcare system. The relative risk for 30-day, 180-day, and 1-year mortality were 7.32 (95% confidence interval [CI], 5.94–9.02), 3.55 (95%CI, 3.17–3.97), and 2.59 (95%CI, 2.37–2.83), respectively. Mean attributable cumulative 30-day, 180-day, and 1-year costs (unadjusted for survival) were $7,434 (95%CI, $7,122-$7,762), $12,517 (95%CI, $11,687-$13,366), and $13,217 (95%CI, $12,062-$14,388). Mean attributable cumulative 1-, 2-, and 3-year costs (adjusted for survival) were $10,700 (95%CI, $9,811-$11,645), $13,312 (95%CI, $12,024-$14,682), and $15,812 (95%CI, $14,159-$17,571). Infected subjects had considerably higher risk of all-cause mortality and costs compared with uninfected subjects. This study provides insight on an understudied patient group. Our study findings will facilitate assessment of interventions to prevent community-onset CDI.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 92%

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A population-based matched cohort study examining the mortality and costs of patients with community-onset Clostridium difficile infection identified using emergency department visits and hospital admissions

et al. 2017

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“…Patients with HCFA-CDI received more PPIs and antibiotics within 6 months prior to CDI diagnosis, which is consistent with other studies [8].…”

Section: Ca-cdi Vs Hcfa-cdisupporting

confidence: 91%

An insight into Clostridium difficile infection: a single-center retrospective case-control study

et al. 2019

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Background Clostridium difficile infection (CDI) has become a worldwide health problem in view of its significant incidence and medical and economic impact on the health system. Prior studies have been undergone about risk factors and disease characteristics. We wanted to study the characteristics, prognostic factors associated with CDI at our institute, as well as a new prognostic factor. Methods Our study aimed at describing the risk factors, patient characteristics, and outcomes associated with healthcare facility–acquired CDI (HCFA-CDI) and community-acquired CDI (CA-CDI). We intended to identify the factors associated with worse outcomes. We evaluated the characteristics associated with CDI over 3 years. We also evaluated a simple neutrophil-lymphocyte ratio (NLR) and its predictive value for worse outcomes. Results Six hundred patients were enrolled (333 in a control group; 171 in the HCFA-CDI group and 96 in the CA-CDI group). NLR > 5 predicted increased mortality and intensive care unit transfer in all CDI if done as early as day 2 after CDI diagnosis. In HCFA-CDI, NLR > 5 predicted a higher ICU transfer if done as early as day 1 post-diagnosis and with increased mortality as early as day 2 post-diagnosis. In CA-CDI, NLR > 5 predicted a higher mortality and ICU transfer if done at least 4 days after diagnosis. Moreover, every 10-unit increase in NLR was associated with a significant increase in mortality and ICU transfer in patients with CDI. Conclusion A timely use of NLR can be used as a mean to predict worse outcomes, namely ICU transfer and mortality, in patients with CDI.

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“…By contrast, Clohessy et al did not find any differences between CA-CDI and HCA-CDI in terms of severity and outcome in Australian patients 21 . Nevertheless, our study did not explore patients with CA-CDI who were treated outside of a hospital setting.…”

Section: Page 11 Of 24mentioning

confidence: 82%

Emergence of community-acquired Clostridium difficile infection: the experience of a French hospital and review of the literature

Ogielska

Lanotte

Brun

et al. 2015

International Journal of Infectious Diseases

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Severity and frequency of community-onset Clostridium difficile infection on an Australian tertiary referral hospital campus

Cited by 12 publications

References 17 publications

A population-based matched cohort study examining the mortality and costs of patients with community-onset Clostridium difficile infection identified using emergency department visits and hospital admissions

A population-based matched cohort study examining the mortality and costs of patients with community-onset Clostridium difficile infection identified using emergency department visits and hospital admissions

An insight into Clostridium difficile infection: a single-center retrospective case-control study

Emergence of community-acquired Clostridium difficile infection: the experience of a French hospital and review of the literature

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