Journal article
Comorbidities, exposure to medications, and the risk of community-acquired clostridium difficile infection: A systematic review and meta-analysis
Infection Control & Hospital Epidemiology, Vol.36(02), pp.132-141
2015
Abstract
Background. Clostridium difficile infection (CDI) has been extensively escribedin healthcare settings; however, risk factor sassociated with community-acquired (CA) CDI remain uncertain. This study aimed to synthesize the current evidence for an association between commonly prescribed medications and comorbidities with CA-CDI. methods. A systematic search was conducted in 5 electronic databases for epidemiologicstudi esthatexamined the associtation between the presence of comorbidities and exposure to medications with the risk of CA-CDI. Pooled odds ratios were estimated using 3 meta-analytic methods. Subgroup analyses by location of studies and by life stages were conducted. results. Twelve publications (n=56,776 patients) met inclusion criteria. Antimicrobial (odds ratio, 6.18; 95% CI, 3.80-10.04) and corticosteroid (1.81; 1.15-2.84) exposure were associated with increased risk of CA-CDI. Among the comorbidities, inflammatory bowel disease (odds ratio, 3.72; 95% CI, 1.52-9.12), renal failure (2.64; 1.23-5.68), hematologic cancer (1.75; 1.02-5.68), and diabetes mellitus (1.15; 1.05-1.27) were associated with CA-CDI. By location, antimicrobial exposure was associated with a higher risk of CA-CDI in the United States, whereas proton-pump inhibitor exposure was associated with a higher risk in Europe. By life stages, the risk of CA-CDI associated with antimicrobial exposure greatly increased in adults older than 65 years. conclusions. Antimicrobial exposure was the strongest risk factor associated with CA-CDI. Further studies are required to investigate the risk of CA-CDI associated with medications commonly prescribed in the community. Patients with diarrhea who have inflammatory bowel disease, renal failure, hematologic cancer, or diabetes are appropriate populations for interventional studies of screening.
Details
- Title
- Comorbidities, exposure to medications, and the risk of community-acquired clostridium difficile infection: A systematic review and meta-analysis
- Authors/Creators
- L. Furuya-Kanamori (Author/Creator)J.C. Stone (Author/Creator)J. Clark (Author/Creator)S.J. McKenzie (Author/Creator)L. Yakob (Author/Creator)D.L. Paterson (Author/Creator)T.V. Riley (Author/Creator)S.A.R. Doi (Author/Creator)A.C. Clements (Author/Creator)
- Publication Details
- Infection Control & Hospital Epidemiology, Vol.36(02), pp.132-141
- Publisher
- University of Chicago Press
- Identifiers
- 991005543568307891
- Copyright
- © 2014 by The Society for Healthcare Epidemiology of America.
- Murdoch Affiliation
- Murdoch University
- Language
- English
- Resource Type
- Journal article
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- Collaboration types
- Domestic collaboration
- International collaboration
- Citation topics
- 1 Clinical & Life Sciences
- 1.120 Inflammatory Bowel Diseases & Infections
- 1.120.1133 Clostridium Infections
- Web Of Science research areas
- Infectious Diseases
- Public, Environmental & Occupational Health
- ESI research areas
- Social Sciences, general