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Risk factors for Clostridium difficile infection in hemato-oncological patients: A case control study in 144 patients
Evidence on risk factors for Clostridium difficile infection (CDI) in hemato-oncologic patients is conflicting. We studied risk factors for CDI in a large, well-characterized cohort of hemato-oncological patients. 144 hemato-oncological patients were identified in this retrospective, single center s...
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| Published in: | Scientific reports 2016-08, Vol.6 (1), p.31498-31498, Article 31498 |
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| creator | Fuereder, Thorsten Koni, Danjel Gleiss, Andreas Kundi, Michael Makristathis, Athanasios Zielinski, Christoph Steininger, Christoph |
| description | Evidence on risk factors for Clostridium difficile infection (CDI) in hemato-oncologic patients is conflicting. We studied risk factors for CDI in a large, well-characterized cohort of hemato-oncological patients. 144 hemato-oncological patients were identified in this retrospective, single center study with a microbiologically confirmed CDI-associated diarrhea. Patients were compared with 144 age and sex matched hemato-oncologic patients with CDI negative diarrhea. Risk factors such as prior antimicrobial therapy, type of disease, chemotherapy and survival were evaluated. CDI-positive patients received more frequently any antimicrobial agent and antimicrobial combination therapy than CDI-negative patients (79% vs. 67%; OR = 2.26, p = 0.038 and OR = 2.62, p = 0.003, respectively). CDI positive patients were treated more frequently with antimicrobial agents active against
C. difficile
than CDI negative ones (25% vs. 13%; OR = 2.2, p = 0.039). The interval between last chemotherapy and onset of diarrhea was significantly shorter in patients without CDI (median, 17 days vs 36 days; p |
| doi_str_mv | 10.1038/srep31498 |
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C. difficile
than CDI negative ones (25% vs. 13%; OR = 2.2, p = 0.039). The interval between last chemotherapy and onset of diarrhea was significantly shorter in patients without CDI (median, 17 days vs 36 days; p < 0.001). Our study demonstrates that chemotherapy is not a significant risk factor for CDI but for early onset CDI negative diarrhea. The predominant modifiable risk factor for CDI is in hemato-oncological patients antimicrobial treatment. These findings should be taken into account in the daily clinical practice to avoid CDI associated complications and excess health care costs.</description><identifier>ISSN: 2045-2322</identifier><identifier>EISSN: 2045-2322</identifier><identifier>DOI: 10.1038/srep31498</identifier><identifier>PMID: 27510591</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>692/4028/67 ; 692/699/255/1911 ; Adult ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents - therapeutic use ; Case-Control Studies ; Clostridium Infections - drug therapy ; Clostridium Infections - epidemiology ; Cross Infection - microbiology ; Diarrhea - microbiology ; Drug Therapy ; Drug Therapy, Combination ; Female ; Hematologic Neoplasms - complications ; Hematologic Neoplasms - drug therapy ; Hematologic Neoplasms - microbiology ; Humanities and Social Sciences ; Humans ; Male ; Middle Aged ; multidisciplinary ; Retrospective Studies ; Risk Factors ; Science ; Science (multidisciplinary) ; Young Adult</subject><ispartof>Scientific reports, 2016-08, Vol.6 (1), p.31498-31498, Article 31498</ispartof><rights>The Author(s) 2016</rights><rights>Copyright © 2016, The Author(s) 2016 The Author(s)</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c410t-d90668ed0b1242ba2f1e14b21f8f7e51f6d5d06000f516c836c91b9377798fca3</citedby><cites>FETCH-LOGICAL-c410t-d90668ed0b1242ba2f1e14b21f8f7e51f6d5d06000f516c836c91b9377798fca3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4980611/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4980611/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,36990,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27510591$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fuereder, Thorsten</creatorcontrib><creatorcontrib>Koni, Danjel</creatorcontrib><creatorcontrib>Gleiss, Andreas</creatorcontrib><creatorcontrib>Kundi, Michael</creatorcontrib><creatorcontrib>Makristathis, Athanasios</creatorcontrib><creatorcontrib>Zielinski, Christoph</creatorcontrib><creatorcontrib>Steininger, Christoph</creatorcontrib><title>Risk factors for Clostridium difficile infection in hemato-oncological patients: A case control study in 144 patients</title><title>Scientific reports</title><addtitle>Sci Rep</addtitle><addtitle>Sci Rep</addtitle><description>Evidence on risk factors for Clostridium difficile infection (CDI) in hemato-oncologic patients is conflicting. We studied risk factors for CDI in a large, well-characterized cohort of hemato-oncological patients. 144 hemato-oncological patients were identified in this retrospective, single center study with a microbiologically confirmed CDI-associated diarrhea. Patients were compared with 144 age and sex matched hemato-oncologic patients with CDI negative diarrhea. Risk factors such as prior antimicrobial therapy, type of disease, chemotherapy and survival were evaluated. CDI-positive patients received more frequently any antimicrobial agent and antimicrobial combination therapy than CDI-negative patients (79% vs. 67%; OR = 2.26, p = 0.038 and OR = 2.62, p = 0.003, respectively). CDI positive patients were treated more frequently with antimicrobial agents active against
C. difficile
than CDI negative ones (25% vs. 13%; OR = 2.2, p = 0.039). The interval between last chemotherapy and onset of diarrhea was significantly shorter in patients without CDI (median, 17 days vs 36 days; p < 0.001). Our study demonstrates that chemotherapy is not a significant risk factor for CDI but for early onset CDI negative diarrhea. The predominant modifiable risk factor for CDI is in hemato-oncological patients antimicrobial treatment. These findings should be taken into account in the daily clinical practice to avoid CDI associated complications and excess health care costs.</description><subject>692/4028/67</subject><subject>692/699/255/1911</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Case-Control Studies</subject><subject>Clostridium Infections - drug therapy</subject><subject>Clostridium Infections - epidemiology</subject><subject>Cross Infection - microbiology</subject><subject>Diarrhea - microbiology</subject><subject>Drug Therapy</subject><subject>Drug Therapy, Combination</subject><subject>Female</subject><subject>Hematologic Neoplasms - complications</subject><subject>Hematologic Neoplasms - drug therapy</subject><subject>Hematologic Neoplasms - microbiology</subject><subject>Humanities and Social Sciences</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>multidisciplinary</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Science</subject><subject>Science (multidisciplinary)</subject><subject>Young Adult</subject><issn>2045-2322</issn><issn>2045-2322</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><recordid>eNptkd9LHDEQx0Ox1OPqQ_-BkscqbJvJZn_EB0EOtQVBkPY5ZLPJGZtNrklWuP_eyNnjBOclA_OZ70zmi9AXIN-B1P2PFPWmBsb7D2hBCWsqWlN6dJAfo5OUHkmJhnIG_BM6pl0DpOGwQPO9TX-xkSqHmLAJEa9cSDna0c4THq0xVlmnsfVGq2yDLxl-0JPMoQpeBRfWVkmHNzJb7XM6x5dYyaSxCj7H4HDK87h9aQLG9tRn9NFIl_TJ67tEf66vfq9-Vrd3N79Wl7eVYkByNXLStr0eyQCU0UFSAxrYQMH0ptMNmHZsRtKWn5kGWtXXreIw8LrrOt4bJeslutjpbuZh0qMqs6N0YhPtJONWBGnF24q3D2IdnkQ5J2kBisC3V4EY_s06ZTHZpLRz0uswJwE9AOWU1U1BT3eoiiEVU8x-DBDx4pTYO1XYr4d77cn_vhTgbAekUvJrHcVjmKMvt3pH7Rk6xJ75</recordid><startdate>20160811</startdate><enddate>20160811</enddate><creator>Fuereder, Thorsten</creator><creator>Koni, Danjel</creator><creator>Gleiss, Andreas</creator><creator>Kundi, Michael</creator><creator>Makristathis, Athanasios</creator><creator>Zielinski, Christoph</creator><creator>Steininger, Christoph</creator><general>Nature Publishing Group UK</general><general>Nature Publishing Group</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20160811</creationdate><title>Risk factors for Clostridium difficile infection in hemato-oncological patients: A case control study in 144 patients</title><author>Fuereder, Thorsten ; Koni, Danjel ; Gleiss, Andreas ; Kundi, Michael ; Makristathis, Athanasios ; Zielinski, Christoph ; Steininger, Christoph</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c410t-d90668ed0b1242ba2f1e14b21f8f7e51f6d5d06000f516c836c91b9377798fca3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>692/4028/67</topic><topic>692/699/255/1911</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>Case-Control Studies</topic><topic>Clostridium Infections - drug therapy</topic><topic>Clostridium Infections - epidemiology</topic><topic>Cross Infection - microbiology</topic><topic>Diarrhea - microbiology</topic><topic>Drug Therapy</topic><topic>Drug Therapy, Combination</topic><topic>Female</topic><topic>Hematologic Neoplasms - complications</topic><topic>Hematologic Neoplasms - drug therapy</topic><topic>Hematologic Neoplasms - microbiology</topic><topic>Humanities and Social Sciences</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>multidisciplinary</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Science</topic><topic>Science (multidisciplinary)</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fuereder, Thorsten</creatorcontrib><creatorcontrib>Koni, Danjel</creatorcontrib><creatorcontrib>Gleiss, Andreas</creatorcontrib><creatorcontrib>Kundi, Michael</creatorcontrib><creatorcontrib>Makristathis, Athanasios</creatorcontrib><creatorcontrib>Zielinski, Christoph</creatorcontrib><creatorcontrib>Steininger, Christoph</creatorcontrib><collection>SpringerOpen</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Scientific reports</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fuereder, Thorsten</au><au>Koni, Danjel</au><au>Gleiss, Andreas</au><au>Kundi, Michael</au><au>Makristathis, Athanasios</au><au>Zielinski, Christoph</au><au>Steininger, Christoph</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk factors for Clostridium difficile infection in hemato-oncological patients: A case control study in 144 patients</atitle><jtitle>Scientific reports</jtitle><stitle>Sci Rep</stitle><addtitle>Sci Rep</addtitle><date>2016-08-11</date><risdate>2016</risdate><volume>6</volume><issue>1</issue><spage>31498</spage><epage>31498</epage><pages>31498-31498</pages><artnum>31498</artnum><issn>2045-2322</issn><eissn>2045-2322</eissn><abstract>Evidence on risk factors for Clostridium difficile infection (CDI) in hemato-oncologic patients is conflicting. We studied risk factors for CDI in a large, well-characterized cohort of hemato-oncological patients. 144 hemato-oncological patients were identified in this retrospective, single center study with a microbiologically confirmed CDI-associated diarrhea. Patients were compared with 144 age and sex matched hemato-oncologic patients with CDI negative diarrhea. Risk factors such as prior antimicrobial therapy, type of disease, chemotherapy and survival were evaluated. CDI-positive patients received more frequently any antimicrobial agent and antimicrobial combination therapy than CDI-negative patients (79% vs. 67%; OR = 2.26, p = 0.038 and OR = 2.62, p = 0.003, respectively). CDI positive patients were treated more frequently with antimicrobial agents active against
C. difficile
than CDI negative ones (25% vs. 13%; OR = 2.2, p = 0.039). The interval between last chemotherapy and onset of diarrhea was significantly shorter in patients without CDI (median, 17 days vs 36 days; p < 0.001). Our study demonstrates that chemotherapy is not a significant risk factor for CDI but for early onset CDI negative diarrhea. The predominant modifiable risk factor for CDI is in hemato-oncological patients antimicrobial treatment. These findings should be taken into account in the daily clinical practice to avoid CDI associated complications and excess health care costs.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>27510591</pmid><doi>10.1038/srep31498</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | 692/4028/67 692/699/255/1911 Adult Aged Aged, 80 and over Anti-Bacterial Agents - therapeutic use Case-Control Studies Clostridium Infections - drug therapy Clostridium Infections - epidemiology Cross Infection - microbiology Diarrhea - microbiology Drug Therapy Drug Therapy, Combination Female Hematologic Neoplasms - complications Hematologic Neoplasms - drug therapy Hematologic Neoplasms - microbiology Humanities and Social Sciences Humans Male Middle Aged multidisciplinary Retrospective Studies Risk Factors Science Science (multidisciplinary) Young Adult |
| title | Risk factors for Clostridium difficile infection in hemato-oncological patients: A case control study in 144 patients |
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