Identification of target risk groups for population-based Clostridium difficile infection prevention strategies using a population attributable risk approach

Sung Hee Oh, Hye-Young Kang

Research output: Contribution to journalArticle

Abstract

Objectives We aimed to determine risk factors associated with Clostridium difficile infection (CDI) and assess the contributions of these factors on CDI burden. Methods We conducted a 1:4 matched case-control study using a national claims dataset. Cases were incident CDI without a history of CDI in the previous 84 days, and were age- and sex-matched with control patients. We ascertained exposure, defined as a history of morbidities and drug use within 90 days. The population attributable risk (PAR) percent for risk factors was estimated using odds ratios (ORs) obtained from the case-control study. Results Overall, the strongest CDI-associated risk factors, which have significant contributions to the CDI burden as well, were the experience of gastroenteritis (OR = 5.08, PAR% = 17.09%) and use of antibiotics (OR = 1.69, PAR% = 19.00%), followed by the experiences of female pelvic infection, irritable bowel syndrome, inflammatory bowel disease, and pneumonia, and use of proton-pump inhibitors (OR = 1.52–2.37, PAR% = 1.95–2.90). Conclusions The control of risk factors that had strong association with CDI and affected large proportions of total CDI cases would be beneficial for CDI prevention. We suggest performing CDI testing for symptomatic patients with gastroenteritis and implementing antibiotics stewardship.

Original languageEnglish
Pages (from-to)107-112
Number of pages6
JournalInternational Journal of Infectious Diseases
Volume66
DOIs
Publication statusPublished - 2018 Jan 1

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Clostridium Infections
Clostridium difficile
Population Groups
Population
Odds Ratio
Gastroenteritis
Case-Control Studies
Pelvic Infection
Anti-Bacterial Agents
Irritable Bowel Syndrome
Proton Pump Inhibitors
Inflammatory Bowel Diseases
Pneumonia
Morbidity

All Science Journal Classification (ASJC) codes

  • Microbiology (medical)
  • Infectious Diseases

Cite this

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title = "Identification of target risk groups for population-based Clostridium difficile infection prevention strategies using a population attributable risk approach",
abstract = "Objectives We aimed to determine risk factors associated with Clostridium difficile infection (CDI) and assess the contributions of these factors on CDI burden. Methods We conducted a 1:4 matched case-control study using a national claims dataset. Cases were incident CDI without a history of CDI in the previous 84 days, and were age- and sex-matched with control patients. We ascertained exposure, defined as a history of morbidities and drug use within 90 days. The population attributable risk (PAR) percent for risk factors was estimated using odds ratios (ORs) obtained from the case-control study. Results Overall, the strongest CDI-associated risk factors, which have significant contributions to the CDI burden as well, were the experience of gastroenteritis (OR = 5.08, PAR{\%} = 17.09{\%}) and use of antibiotics (OR = 1.69, PAR{\%} = 19.00{\%}), followed by the experiences of female pelvic infection, irritable bowel syndrome, inflammatory bowel disease, and pneumonia, and use of proton-pump inhibitors (OR = 1.52–2.37, PAR{\%} = 1.95–2.90). Conclusions The control of risk factors that had strong association with CDI and affected large proportions of total CDI cases would be beneficial for CDI prevention. We suggest performing CDI testing for symptomatic patients with gastroenteritis and implementing antibiotics stewardship.",
author = "Oh, {Sung Hee} and Hye-Young Kang",
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N2 - Objectives We aimed to determine risk factors associated with Clostridium difficile infection (CDI) and assess the contributions of these factors on CDI burden. Methods We conducted a 1:4 matched case-control study using a national claims dataset. Cases were incident CDI without a history of CDI in the previous 84 days, and were age- and sex-matched with control patients. We ascertained exposure, defined as a history of morbidities and drug use within 90 days. The population attributable risk (PAR) percent for risk factors was estimated using odds ratios (ORs) obtained from the case-control study. Results Overall, the strongest CDI-associated risk factors, which have significant contributions to the CDI burden as well, were the experience of gastroenteritis (OR = 5.08, PAR% = 17.09%) and use of antibiotics (OR = 1.69, PAR% = 19.00%), followed by the experiences of female pelvic infection, irritable bowel syndrome, inflammatory bowel disease, and pneumonia, and use of proton-pump inhibitors (OR = 1.52–2.37, PAR% = 1.95–2.90). Conclusions The control of risk factors that had strong association with CDI and affected large proportions of total CDI cases would be beneficial for CDI prevention. We suggest performing CDI testing for symptomatic patients with gastroenteritis and implementing antibiotics stewardship.

AB - Objectives We aimed to determine risk factors associated with Clostridium difficile infection (CDI) and assess the contributions of these factors on CDI burden. Methods We conducted a 1:4 matched case-control study using a national claims dataset. Cases were incident CDI without a history of CDI in the previous 84 days, and were age- and sex-matched with control patients. We ascertained exposure, defined as a history of morbidities and drug use within 90 days. The population attributable risk (PAR) percent for risk factors was estimated using odds ratios (ORs) obtained from the case-control study. Results Overall, the strongest CDI-associated risk factors, which have significant contributions to the CDI burden as well, were the experience of gastroenteritis (OR = 5.08, PAR% = 17.09%) and use of antibiotics (OR = 1.69, PAR% = 19.00%), followed by the experiences of female pelvic infection, irritable bowel syndrome, inflammatory bowel disease, and pneumonia, and use of proton-pump inhibitors (OR = 1.52–2.37, PAR% = 1.95–2.90). Conclusions The control of risk factors that had strong association with CDI and affected large proportions of total CDI cases would be beneficial for CDI prevention. We suggest performing CDI testing for symptomatic patients with gastroenteritis and implementing antibiotics stewardship.

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