Correlation between hospital-level antibiotic consumption and incident health care facility-onset Clostridium difficile infection - 01/03/18
Highlights |
• | Antibiotic consumption may have an immediate and prolonged impact on incident CDI. |
• | Delayed temporal associations may exist between antibiotic use and CDI. |
• | Further research is needed to understand ward-level risk factors for CDI. |
Abstract |
Background |
The purpose of this single-center, ecologic study is to characterize the relationship between facility-wide (FacWide) antibiotic consumption and incident health care facility-onset Clostridium difficile infection (HO-CDI).
Methods |
FacWide antibiotic consumption and incident HO-CDI were tallied on a monthly basis and standardized, from January 2013 through April 2015. Spearman rank-order correlation coefficients were calculated using matched-months analysis and a 1-month delay. Regression analyses were performed, with P < .05 considered statistically significant.
Results |
FacWide analysis identified a matched-months correlation between ceftriaxone and HO-CDI (ρ = 0.44, P = .018). A unit of stem cell transplant recipients did not have significant correlation between carbapenems and HO-CDI in matched months (ρ = 0.37, P = .098), but a significant correlation was observed when a 1-month lag was applied (ρ = 0.54, P = .014).
Discussion |
Three statistically significant lag associations were observed between FacWide/unit-level antibiotic consumption and HO-CDI, and 1 statistically significant nonlagged association was observed FacWide. Antibiotic consumption may convey extended ward-level risk for incident CDI.
Conclusions |
Consumption of antibiotic agents may have immediate and prolonged influence on incident CDI. Additional studies are needed to investigate the immediate and delayed associations between antibiotic consumption and C difficile colonization, infection, and transmission at the hospital level.
El texto completo de este artículo está disponible en PDF.Key Words : Antimicrobial stewardship, Healthcare-associated infections, Antibiotic use, Statistical model
Esquema
| PEC is currently with Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD. |
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| EMG is currently with Janssen Scientific Affairs, LLC, Titusville, NJ. |
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| The views expressed are those of the authors and do not necessarily represent those of, nor imply endorsement from, the US Food and Drug Administration or the US government. |
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| Conflicts of interest: None to report. |
Vol 46 - N° 3
P. 270-275 - mars 2018 Regresar al número
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