Unknown

Dataset Information

0

Epidemiologic Trends in Clostridioides difficile Infections in a Regional Community Hospital Network.


ABSTRACT: Importance:Clostridioides difficile infection (CDI) remains a leading cause of health care facility-associated infection. A greater understanding of the regional epidemiologic profile of CDI could inform targeted prevention strategies. Objectives:To assess trends in incidence of health care facility-associated and community-acquired CDI among hospitalized patients over time and to conduct a subanalysis of trends in the NAP1 strain of CDI over time. Design, Setting, and Participants:This long-term multicenter cohort study reviewed records of patients (N = 2?025?678) admitted to a network of 43 regional community hospitals primarily in the southeastern United States from January 1, 2013, through December 31, 2017. Generalized linear mixed-effects models were used to adjust for potential clustering within facilities and changing test method (nucleic acid amplification testing or toxin enzyme immunoassay) over time. Main Outcomes and Measures:Clostridioides difficile infection incidence rates were counted as cases per 1000 admissions for community-acquired and total CDI cases or cases per 10?000 patient-days for health care facility-associated CDI. Long-term trends in the proportion of cases acquired in the community and in NAP1 strain incidence were also evaluated. Results:A total of 2?025?678 admissions and 21?254 CDI cases were included (12 678 [59.6%] female; median [interquartile range] age, 69 [55-80] years). Median (interquartile range) total CDI incidence increased slightly from 7.9 (3.5-12.4) cases per 1000 admissions in 2013 to 9.3 (4.9-13.7) cases per 1000 admissions in 2017. After adjustment, the overall incidence of health care facility-associated CDI declined (incidence rate ratio [IRR], 0.995; 95% CI, 0.990-0.999; P?=?.03), whereas insufficient evidence was found for either an increase or a decrease in community-acquired CDI (IRR, 1.004; 95% CI, 0.999-1.009; P?=?.14). The proportion of cases classified as community acquired increased over time from a mean (SD) of 0.49 (0.28) in 2013 to 0.61 (0.26) in 2017 (odds ratio, 1.010 per month; 95% CI, 1.006-1.015; P?

SUBMITTER: Turner NA 

PROVIDER: S-EPMC6824221 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

altmetric image

Publications

Epidemiologic Trends in Clostridioides difficile Infections in a Regional Community Hospital Network.

Turner Nicholas A NA   Grambow Steven C SC   Woods Christopher W CW   Fowler Vance G VG   Moehring Rebekah W RW   Anderson Deverick J DJ   Lewis Sarah S SS  

JAMA network open 20191002 10


<h4>Importance</h4>Clostridioides difficile infection (CDI) remains a leading cause of health care facility-associated infection. A greater understanding of the regional epidemiologic profile of CDI could inform targeted prevention strategies.<h4>Objectives</h4>To assess trends in incidence of health care facility-associated and community-acquired CDI among hospitalized patients over time and to conduct a subanalysis of trends in the NAP1 strain of CDI over time.<h4>Design, setting, and particip  ...[more]

Similar Datasets

| S-EPMC6606746 | biostudies-literature
| S-EPMC8147471 | biostudies-literature
| S-EPMC6724465 | biostudies-literature
| S-EPMC6929054 | biostudies-literature
2022-04-09 | GSE200346 | GEO
| S-EPMC7179314 | biostudies-literature
| S-EPMC10228158 | biostudies-literature
| S-EPMC6934170 | biostudies-literature
| S-EPMC7269495 | biostudies-literature
| S-EPMC6715368 | biostudies-literature