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Deprecated: Implicit conversion from float 251.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Am+J+Infect+Control 2019 ; 47 (1): 2-8 Nephropedia Template TP
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Predictors of Clostridium difficile Infection and Predictive Impact of Probiotic Use in a Diverse Hospital-Wide Cohort #MMPMID30205907
Carvour ML; Wilder SL; Ryan KL; Walraven C; Qeadan F; Brett M; Page K
Am J Infect Control 2019[Jan]; 47 (1): 2-8 PMID30205907show ga
Background:: Hospital-based predictive models for Clostridium difficile infection (CDI) may aid with surveillance efforts. Methods:: A retrospective cohort of adult hospitalized patients who were tested for CDI between May 1, 2011 and August 31, 2016 was formed. Proposed clinical and sociodemographic predictors of CDI were evaluated using multivariable predictive logistic regression modeling. Results:: In a cohort of 5209 patients, including 1092 CDI cases, emergency department location (adjusted odds ratio, aOR=1.91; 95% confidence interval, CI: 1.51, 2.41; compared to an intensive care unit reference category, which had the lowest observed odds in the study) and prior exposure to a statin (aOR=1.26, 95% CI: 1.06, 1.51), probiotic (aOR=1.39, 95% CI: 1.08, 1.80), or high risk antibiotic (aOR=1.54; 95% CI: 1.29, 1.84), such as a cephalosporin, a quinolone, or clindamycin, were independent predictors of CDI. Probiotic use did not appear to attenuate the odds of CDI in patients exposed to high risk antibiotics, but moderate risk antibiotics appeared to significantly attenuate the odds of CDI in patients who received probiotics. Discussion/Conclusions:: Emergency department location, high risk antibiotics, probiotics, and statins were independently predictive of CDI. Further exploration of the relationship between probiotics and CDI, especially in diverse patient populations, is warranted.