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Recent trends and risk factors associated with Clostridioides difficile infections in hospitalized patients with inflammatory bowel disease
Summary Background Clostridioides difficile infections (CDIs) are common among patients with inflammatory bowel disease (IBD) and can mimic and exacerbate IBD flares, thus warranting appropriate testing during flares. Aims To examine recent trends in rates of CDI and associated risk factors in hospi...
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| Published in: | Alimentary pharmacology & therapeutics 2024-01, Vol.59 (1), p.89-99 |
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| container_issue | 1 |
| container_start_page | 89 |
| container_title | Alimentary pharmacology & therapeutics |
| container_volume | 59 |
| creator | Spartz, Ellen J. DeDecker, Lauren C. Fansiwala, Kush M. Noorian, Shaya Roney, Andrew R. Hakimian, Shahrad Sauk, Jenny S. Chen, Po‐Hung Limketkai, Berkeley N. |
| description | Summary
Background
Clostridioides difficile infections (CDIs) are common among patients with inflammatory bowel disease (IBD) and can mimic and exacerbate IBD flares, thus warranting appropriate testing during flares.
Aims
To examine recent trends in rates of CDI and associated risk factors in hospitalized IBD patients, which may better inform targeted interventions to mitigate the risk of infection.
Methods
This is a retrospective analysis using the Nationwide Readmissions Database from 2010 to 2020 of hospitalized individuals with Crohn's disease (CD) or ulcerative colitis (UC). Longitudinal changes in rates of CDI were evaluated using International Classification of Diseases codes. Multivariable logistic regression evaluated the association between patient‐ and hospital‐related factors and CDI.
Results
There were 2,521,935 individuals with IBD who were hospitalized at least once during the study period. Rates of CDI in IBD‐related hospitalizations increased from 2010 to 2015 (CD: 1.64%–3.32%, p |
| doi_str_mv | 10.1111/apt.17777 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2881245895</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2900732200</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3137-ccae87c54152861ec01cfdb8694398cef27239f57519a9c2fa5ae99eb6eadbbe3</originalsourceid><addsrcrecordid>eNp1kc9qFTEUh4NY7LW68AUk4EYX0-bPnUmyLBe1QqEidR0ymROaOjMZc3K5XF_BlzY6rQvBszkhfPlOOD9CXnF2zmtduKWcc1XrCdlw2bWNYLJ7SjZMdKYRmstT8hzxnjHWKSaekVOptJJa6Q35-QU8zIWWDPOA1M0DzRG_0eB8SbleICYfXYGBHmK5o7sxYclxiCkOgHSIIUQfR6BxDuBLTDPWI71LuMTixvijPlxciXUGroYKjm6aXNUfaZ8OMFYLgkN4QU6CGxFePvQz8vXD-9vdVXN98_HT7vK68ZJL1XjvQCvfbnkrdMfBM-7D0OvObKXRHoJQQprQqpYbZ7wIrnVgDPQduKHvQZ6Rt6t3yen7HrDYKaKHcXQzpD1aoTUX21abtqJv_kHv0z7P9XdWGMaUFIKxSr1bKZ8TYoZglxwnl4-WM_s7IVsTsn8SquzrB-O-n2D4Sz5GUoGLFTjUtR7_b7KXn29X5S8MIJ56</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2900732200</pqid></control><display><type>article</type><title>Recent trends and risk factors associated with Clostridioides difficile infections in hospitalized patients with inflammatory bowel disease</title><source>Wiley:Jisc Collections:Wiley Read and Publish Open Access 2024-2025 (reading list)</source><creator>Spartz, Ellen J. ; DeDecker, Lauren C. ; Fansiwala, Kush M. ; Noorian, Shaya ; Roney, Andrew R. ; Hakimian, Shahrad ; Sauk, Jenny S. ; Chen, Po‐Hung ; Limketkai, Berkeley N.</creator><creatorcontrib>Spartz, Ellen J. ; DeDecker, Lauren C. ; Fansiwala, Kush M. ; Noorian, Shaya ; Roney, Andrew R. ; Hakimian, Shahrad ; Sauk, Jenny S. ; Chen, Po‐Hung ; Limketkai, Berkeley N.</creatorcontrib><description>Summary
Background
Clostridioides difficile infections (CDIs) are common among patients with inflammatory bowel disease (IBD) and can mimic and exacerbate IBD flares, thus warranting appropriate testing during flares.
Aims
To examine recent trends in rates of CDI and associated risk factors in hospitalized IBD patients, which may better inform targeted interventions to mitigate the risk of infection.
Methods
This is a retrospective analysis using the Nationwide Readmissions Database from 2010 to 2020 of hospitalized individuals with Crohn's disease (CD) or ulcerative colitis (UC). Longitudinal changes in rates of CDI were evaluated using International Classification of Diseases codes. Multivariable logistic regression evaluated the association between patient‐ and hospital‐related factors and CDI.
Results
There were 2,521,935 individuals with IBD who were hospitalized at least once during the study period. Rates of CDI in IBD‐related hospitalizations increased from 2010 to 2015 (CD: 1.64%–3.32%, p < 0.001; UC: 4.15%–5.81%, p < 0.001), followed by a steady decline from 2016 to 2020 (CD: 3.15%–2.27%, p < 0.001; UC: 5.04%–4.27%, p < 0.001). In multivariable models, CDI was associated with the Charlson–Deyo comorbidity index, public insurance, and hospital size. CDI was associated with increased mortality.
Conclusions
Rates of CDI among hospitalized patients with IBD had initially increased, but have declined since 2015. Increased comorbidity, large hospital size, public insurance, and urban teaching hospitals were associated with higher rates of CDI. CDI was associated with increased mortality in hospitalized patients with IBD. Continued vigilance, infection control, and treatment of CDI can help continue the trend of declining infection rates.
Rates are higher in patients with UC than with CD and patients without IBD. Rates of CDI were increasing but have declined since 2015. CDI is associated with increased comorbidity, public insurance, urban teaching hospitals, and larger hospital size. CDI is associated with increased mortality.</description><identifier>ISSN: 0269-2813</identifier><identifier>ISSN: 1365-2036</identifier><identifier>EISSN: 1365-2036</identifier><identifier>DOI: 10.1111/apt.17777</identifier><identifier>PMID: 37873878</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Clostridioides difficile ; Comorbidity ; Crohn's disease ; Hospitalization ; Infections ; Inflammatory bowel disease ; Inflammatory bowel diseases ; Intestine ; Mortality ; Patients ; Risk factors ; Trends ; Ulcerative colitis ; Vigilance</subject><ispartof>Alimentary pharmacology & therapeutics, 2024-01, Vol.59 (1), p.89-99</ispartof><rights>2023 John Wiley & Sons Ltd.</rights><rights>Copyright © 2024 John Wiley & Sons Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3137-ccae87c54152861ec01cfdb8694398cef27239f57519a9c2fa5ae99eb6eadbbe3</cites><orcidid>0000-0001-6750-2441 ; 0000-0001-6731-8193</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37873878$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Spartz, Ellen J.</creatorcontrib><creatorcontrib>DeDecker, Lauren C.</creatorcontrib><creatorcontrib>Fansiwala, Kush M.</creatorcontrib><creatorcontrib>Noorian, Shaya</creatorcontrib><creatorcontrib>Roney, Andrew R.</creatorcontrib><creatorcontrib>Hakimian, Shahrad</creatorcontrib><creatorcontrib>Sauk, Jenny S.</creatorcontrib><creatorcontrib>Chen, Po‐Hung</creatorcontrib><creatorcontrib>Limketkai, Berkeley N.</creatorcontrib><title>Recent trends and risk factors associated with Clostridioides difficile infections in hospitalized patients with inflammatory bowel disease</title><title>Alimentary pharmacology & therapeutics</title><addtitle>Aliment Pharmacol Ther</addtitle><description>Summary
Background
Clostridioides difficile infections (CDIs) are common among patients with inflammatory bowel disease (IBD) and can mimic and exacerbate IBD flares, thus warranting appropriate testing during flares.
Aims
To examine recent trends in rates of CDI and associated risk factors in hospitalized IBD patients, which may better inform targeted interventions to mitigate the risk of infection.
Methods
This is a retrospective analysis using the Nationwide Readmissions Database from 2010 to 2020 of hospitalized individuals with Crohn's disease (CD) or ulcerative colitis (UC). Longitudinal changes in rates of CDI were evaluated using International Classification of Diseases codes. Multivariable logistic regression evaluated the association between patient‐ and hospital‐related factors and CDI.
Results
There were 2,521,935 individuals with IBD who were hospitalized at least once during the study period. Rates of CDI in IBD‐related hospitalizations increased from 2010 to 2015 (CD: 1.64%–3.32%, p < 0.001; UC: 4.15%–5.81%, p < 0.001), followed by a steady decline from 2016 to 2020 (CD: 3.15%–2.27%, p < 0.001; UC: 5.04%–4.27%, p < 0.001). In multivariable models, CDI was associated with the Charlson–Deyo comorbidity index, public insurance, and hospital size. CDI was associated with increased mortality.
Conclusions
Rates of CDI among hospitalized patients with IBD had initially increased, but have declined since 2015. Increased comorbidity, large hospital size, public insurance, and urban teaching hospitals were associated with higher rates of CDI. CDI was associated with increased mortality in hospitalized patients with IBD. Continued vigilance, infection control, and treatment of CDI can help continue the trend of declining infection rates.
Rates are higher in patients with UC than with CD and patients without IBD. Rates of CDI were increasing but have declined since 2015. CDI is associated with increased comorbidity, public insurance, urban teaching hospitals, and larger hospital size. CDI is associated with increased mortality.</description><subject>Clostridioides difficile</subject><subject>Comorbidity</subject><subject>Crohn's disease</subject><subject>Hospitalization</subject><subject>Infections</subject><subject>Inflammatory bowel disease</subject><subject>Inflammatory bowel diseases</subject><subject>Intestine</subject><subject>Mortality</subject><subject>Patients</subject><subject>Risk factors</subject><subject>Trends</subject><subject>Ulcerative colitis</subject><subject>Vigilance</subject><issn>0269-2813</issn><issn>1365-2036</issn><issn>1365-2036</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp1kc9qFTEUh4NY7LW68AUk4EYX0-bPnUmyLBe1QqEidR0ymROaOjMZc3K5XF_BlzY6rQvBszkhfPlOOD9CXnF2zmtduKWcc1XrCdlw2bWNYLJ7SjZMdKYRmstT8hzxnjHWKSaekVOptJJa6Q35-QU8zIWWDPOA1M0DzRG_0eB8SbleICYfXYGBHmK5o7sxYclxiCkOgHSIIUQfR6BxDuBLTDPWI71LuMTixvijPlxciXUGroYKjm6aXNUfaZ8OMFYLgkN4QU6CGxFePvQz8vXD-9vdVXN98_HT7vK68ZJL1XjvQCvfbnkrdMfBM-7D0OvObKXRHoJQQprQqpYbZ7wIrnVgDPQduKHvQZ6Rt6t3yen7HrDYKaKHcXQzpD1aoTUX21abtqJv_kHv0z7P9XdWGMaUFIKxSr1bKZ8TYoZglxwnl4-WM_s7IVsTsn8SquzrB-O-n2D4Sz5GUoGLFTjUtR7_b7KXn29X5S8MIJ56</recordid><startdate>202401</startdate><enddate>202401</enddate><creator>Spartz, Ellen J.</creator><creator>DeDecker, Lauren C.</creator><creator>Fansiwala, Kush M.</creator><creator>Noorian, Shaya</creator><creator>Roney, Andrew R.</creator><creator>Hakimian, Shahrad</creator><creator>Sauk, Jenny S.</creator><creator>Chen, Po‐Hung</creator><creator>Limketkai, Berkeley N.</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>7U9</scope><scope>H94</scope><scope>M7N</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-6750-2441</orcidid><orcidid>https://orcid.org/0000-0001-6731-8193</orcidid></search><sort><creationdate>202401</creationdate><title>Recent trends and risk factors associated with Clostridioides difficile infections in hospitalized patients with inflammatory bowel disease</title><author>Spartz, Ellen J. ; DeDecker, Lauren C. ; Fansiwala, Kush M. ; Noorian, Shaya ; Roney, Andrew R. ; Hakimian, Shahrad ; Sauk, Jenny S. ; Chen, Po‐Hung ; Limketkai, Berkeley N.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3137-ccae87c54152861ec01cfdb8694398cef27239f57519a9c2fa5ae99eb6eadbbe3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Clostridioides difficile</topic><topic>Comorbidity</topic><topic>Crohn's disease</topic><topic>Hospitalization</topic><topic>Infections</topic><topic>Inflammatory bowel disease</topic><topic>Inflammatory bowel diseases</topic><topic>Intestine</topic><topic>Mortality</topic><topic>Patients</topic><topic>Risk factors</topic><topic>Trends</topic><topic>Ulcerative colitis</topic><topic>Vigilance</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Spartz, Ellen J.</creatorcontrib><creatorcontrib>DeDecker, Lauren C.</creatorcontrib><creatorcontrib>Fansiwala, Kush M.</creatorcontrib><creatorcontrib>Noorian, Shaya</creatorcontrib><creatorcontrib>Roney, Andrew R.</creatorcontrib><creatorcontrib>Hakimian, Shahrad</creatorcontrib><creatorcontrib>Sauk, Jenny S.</creatorcontrib><creatorcontrib>Chen, Po‐Hung</creatorcontrib><creatorcontrib>Limketkai, Berkeley N.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>MEDLINE - Academic</collection><jtitle>Alimentary pharmacology & therapeutics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Spartz, Ellen J.</au><au>DeDecker, Lauren C.</au><au>Fansiwala, Kush M.</au><au>Noorian, Shaya</au><au>Roney, Andrew R.</au><au>Hakimian, Shahrad</au><au>Sauk, Jenny S.</au><au>Chen, Po‐Hung</au><au>Limketkai, Berkeley N.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Recent trends and risk factors associated with Clostridioides difficile infections in hospitalized patients with inflammatory bowel disease</atitle><jtitle>Alimentary pharmacology & therapeutics</jtitle><addtitle>Aliment Pharmacol Ther</addtitle><date>2024-01</date><risdate>2024</risdate><volume>59</volume><issue>1</issue><spage>89</spage><epage>99</epage><pages>89-99</pages><issn>0269-2813</issn><issn>1365-2036</issn><eissn>1365-2036</eissn><abstract>Summary
Background
Clostridioides difficile infections (CDIs) are common among patients with inflammatory bowel disease (IBD) and can mimic and exacerbate IBD flares, thus warranting appropriate testing during flares.
Aims
To examine recent trends in rates of CDI and associated risk factors in hospitalized IBD patients, which may better inform targeted interventions to mitigate the risk of infection.
Methods
This is a retrospective analysis using the Nationwide Readmissions Database from 2010 to 2020 of hospitalized individuals with Crohn's disease (CD) or ulcerative colitis (UC). Longitudinal changes in rates of CDI were evaluated using International Classification of Diseases codes. Multivariable logistic regression evaluated the association between patient‐ and hospital‐related factors and CDI.
Results
There were 2,521,935 individuals with IBD who were hospitalized at least once during the study period. Rates of CDI in IBD‐related hospitalizations increased from 2010 to 2015 (CD: 1.64%–3.32%, p < 0.001; UC: 4.15%–5.81%, p < 0.001), followed by a steady decline from 2016 to 2020 (CD: 3.15%–2.27%, p < 0.001; UC: 5.04%–4.27%, p < 0.001). In multivariable models, CDI was associated with the Charlson–Deyo comorbidity index, public insurance, and hospital size. CDI was associated with increased mortality.
Conclusions
Rates of CDI among hospitalized patients with IBD had initially increased, but have declined since 2015. Increased comorbidity, large hospital size, public insurance, and urban teaching hospitals were associated with higher rates of CDI. CDI was associated with increased mortality in hospitalized patients with IBD. Continued vigilance, infection control, and treatment of CDI can help continue the trend of declining infection rates.
Rates are higher in patients with UC than with CD and patients without IBD. Rates of CDI were increasing but have declined since 2015. CDI is associated with increased comorbidity, public insurance, urban teaching hospitals, and larger hospital size. CDI is associated with increased mortality.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>37873878</pmid><doi>10.1111/apt.17777</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0001-6750-2441</orcidid><orcidid>https://orcid.org/0000-0001-6731-8193</orcidid></addata></record> |
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| identifier | ISSN: 0269-2813 |
| ispartof | Alimentary pharmacology & therapeutics, 2024-01, Vol.59 (1), p.89-99 |
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| source | Wiley:Jisc Collections:Wiley Read and Publish Open Access 2024-2025 (reading list) |
| subjects | Clostridioides difficile Comorbidity Crohn's disease Hospitalization Infections Inflammatory bowel disease Inflammatory bowel diseases Intestine Mortality Patients Risk factors Trends Ulcerative colitis Vigilance |
| title | Recent trends and risk factors associated with Clostridioides difficile infections in hospitalized patients with inflammatory bowel disease |
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