Fecal microbiota transplantation and Clostridioides difficile infection among privately insured patients in the United States

Background Clostridioides difficile infection (CDI) may be rising in severity in the US over the past decade and its treatment landscape is changing given the recent adoption of fecal microbiota transplantation (FMT) Methods We built a retrospective observational cohort using a database of a nationa...

Full description

Saved in:
Bibliographic Details
Published in:Journal of gastroenterology 2022, Vol.57 (1), p.10-18
Main Authors: El Halabi, Jessica, Palmer, Nathan, Fox, Kathe, Kohane, Isaac, Farhat, Maha R.
Format: Article
Language:English
Subjects:
Abdominal Surgery
Analysis
Antibiotics
Clostridioides difficile
Clostridium Infections - epidemiology
Clostridium Infections - etiology
Clostridium Infections - therapy
Colorectal Surgery
Fecal Microbiota Transplantation - adverse effects
Fecal microflora
Female
Fidaxomicin
Gastroenterology
Gastrointestinal diseases
Health aspects
Hepatology
Humans
Infection
Insurance, Health
Medical research
Medicine
Medicine & Public Health
Medicine, Experimental
Metronidazole
Microbiota
Microbiota (Symbiotic organisms)
Middle Aged
Original Article—Alimentary Tract
Patients
Recurrence
Retrospective Studies
Sepsis
Surgical Oncology
Transplantation
Treatment Outcome
United States - epidemiology
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background Clostridioides difficile infection (CDI) may be rising in severity in the US over the past decade and its treatment landscape is changing given the recent adoption of fecal microbiota transplantation (FMT) Methods We built a retrospective observational cohort using a database of a national care-plan containing medical claims of over 50 million individuals between 2008 and 2019. We used International Classification of Disease (ICD) and prescription data to identify patients with CDI. We estimated trends in disease burden and FMT use, and evaluated complications post FMT using a phenome-wide association approach. Results We identified 38,396 patients with CDI; the median age was 60 years (IQR 45–74) and 60% were female ( n  = 23,374). The rate of CDI increased from 33.4 to 69.46 cases per 100,000 person-years between 2008 and 2015, and stabilized from 2015 to 2019 (increase of 4.77 cases per 100,000 person-years per year, 95% CI 3.55–5.98 prior to 2015 vs. 2.01 95% CI − 10.16 to 14.18 after 2015). Of the 7715 patients with recurrent CDI, 407 patients (5%) underwent FMT. Gastrointestinal complications were increased within 1 month post FMT (OR 99.60, p  
ISSN:0944-1174
1435-5922
DOI:10.1007/s00535-021-01822-y