Risk factors for recurrent Clostridium difficile infection: a systematic review and meta-analysis.

2.50
Hdl Handle:
http://hdl.handle.net/10757/608263
Title:
Risk factors for recurrent Clostridium difficile infection: a systematic review and meta-analysis.
Authors:
Deshpande, Abhishek; Pasupuleti, Vinay; Thota, Priyaleela; Pant, Chaitanya; Rolston, David D K; Hernandez, Adrian V. ( 0000-0002-9999-4003 ) ; Donskey, Curtis J; Fraser, Thomas G
Citation:
Risk factors for recurrent Clostridium difficile infection: a systematic review and meta-analysis. 2015, 36 (4):452-60 Infect Control Hosp Epidemiol
Publisher:
Cambridge University Press
Journal:
Infection control and hospital epidemiology (Infect Control Hosp Epidemiol)
Issue Date:
Apr-2015
URI:
http://hdl.handle.net/10757/608263
DOI:
10.1017/ice.2014.88
PubMed ID:
25626326
Additional Links:
http://www.ncbi.nlm.nih.gov/pubmed/25626326
Abstract:
OBJECTIVE: An estimated 20-30% of patients with primary Clostridium difficile infection (CDI) develop recurrent CDI (rCDI) within 2 weeks of completion of therapy. While the actual mechanism of recurrence remains unknown, a variety of risk factors have been suggested and studied. The aim of this systematic review and meta-analysis was to evaluate current evidence on the risk factors for rCDI. DESIGN: We searched MEDLINE and 5 other databases for subject headings and text related to rCDI. All studies investigating risk factors of rCDI in a multivariate model were eligible. Information on study design, patient population, and assessed risk factors were collected. Data were combined using a random-effects model and pooled relative risk ratios (RRs) were calculated. RESULTS: A total of 33 studies (n=18,530) met the inclusion criteria. The most frequent independent risk factors associated with rCDI were age≥65 years (risk ratio [RR], 1.63; 95% confidence interval [CI], 1.24-2.14; P=.0005), additional antibiotics during follow-up (RR, 1.76; 95% CI, 1.52-2.05; P<.00001), use of proton-pump inhibitors (PPIs) (RR, 1.58; 95% CI, 1.13-2.21; P=.008), and renal insufficiency (RR, 1.59; 95% CI, 1.14-2.23; P=.007). The risk was also greater in patients previously on fluoroquinolones (RR, 1.42; 95% CI, 1.28-1.57; P<.00001). CONCLUSIONS: Multiple risk factors are associated with the development of rCDI. Identification of modifiable risk factors and judicious use of antibiotics and PPI can play an important role in the prevention of rCDI.
Type:
info:eu-repo/semantics/article
Rights:
info:eu-repo/semantics/openAccess
Language:
eng
Description:
El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado.
Keywords:
Clostridium difficile; Enterocolitis; Humans; Recurrence; Risk Factors
MeSH:
Clostridium difficile; Enterocolitis, Pseudomembranous; Humans; Recurrence; Risk Factors
ISSN:
1559-6834

Full metadata record

DC FieldValue Language
dc.contributor.authorDeshpande, Abhishekes_PE
dc.contributor.authorPasupuleti, Vinayes_PE
dc.contributor.authorThota, Priyaleelaes_PE
dc.contributor.authorPant, Chaitanyaes_PE
dc.contributor.authorRolston, David D Kes_PE
dc.contributor.authorHernandez, Adrian V.es_PE
dc.contributor.authorDonskey, Curtis Jes_PE
dc.contributor.authorFraser, Thomas Ges_PE
dc.date.accessioned2016-05-04T17:57:55Zes_PE
dc.date.available2016-05-04T17:57:55Zes_PE
dc.date.issued2015-04es_PE
dc.identifier.citationRisk factors for recurrent Clostridium difficile infection: a systematic review and meta-analysis. 2015, 36 (4):452-60 Infect Control Hosp Epidemioles_PE
dc.identifier.issn1559-6834es_PE
dc.identifier.pmid25626326es_PE
dc.identifier.doi10.1017/ice.2014.88es_PE
dc.identifier.urihttp://hdl.handle.net/10757/608263es_PE
dc.descriptionEl texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado.es_PE
dc.description.abstractOBJECTIVE: An estimated 20-30% of patients with primary Clostridium difficile infection (CDI) develop recurrent CDI (rCDI) within 2 weeks of completion of therapy. While the actual mechanism of recurrence remains unknown, a variety of risk factors have been suggested and studied. The aim of this systematic review and meta-analysis was to evaluate current evidence on the risk factors for rCDI. DESIGN: We searched MEDLINE and 5 other databases for subject headings and text related to rCDI. All studies investigating risk factors of rCDI in a multivariate model were eligible. Information on study design, patient population, and assessed risk factors were collected. Data were combined using a random-effects model and pooled relative risk ratios (RRs) were calculated. RESULTS: A total of 33 studies (n=18,530) met the inclusion criteria. The most frequent independent risk factors associated with rCDI were age≥65 years (risk ratio [RR], 1.63; 95% confidence interval [CI], 1.24-2.14; P=.0005), additional antibiotics during follow-up (RR, 1.76; 95% CI, 1.52-2.05; P<.00001), use of proton-pump inhibitors (PPIs) (RR, 1.58; 95% CI, 1.13-2.21; P=.008), and renal insufficiency (RR, 1.59; 95% CI, 1.14-2.23; P=.007). The risk was also greater in patients previously on fluoroquinolones (RR, 1.42; 95% CI, 1.28-1.57; P<.00001). CONCLUSIONS: Multiple risk factors are associated with the development of rCDI. Identification of modifiable risk factors and judicious use of antibiotics and PPI can play an important role in the prevention of rCDI.eng
dc.formatapplication/pdfes_PE
dc.language.isoenges_PE
dc.publisherCambridge University Presses_PE
dc.relation.urlhttp://www.ncbi.nlm.nih.gov/pubmed/25626326es_PE
dc.rightsinfo:eu-repo/semantics/openAccesses_PE
dc.sourceUniversidad Peruana de Ciencias Aplicadas (UPC)es_PE
dc.sourceRepositorio Académico - UPCes_PE
dc.subjectClostridium difficilees_PE
dc.subjectEnterocolitises_PE
dc.subjectHumanses_PE
dc.subjectRecurrencees_PE
dc.subjectRisk Factorses_PE
dc.subject.meshClostridium difficilees_PE
dc.subject.meshEnterocolitis, Pseudomembranouses_PE
dc.subject.meshHumanses_PE
dc.subject.meshRecurrencees_PE
dc.subject.meshRisk Factorses_PE
dc.titleRisk factors for recurrent Clostridium difficile infection: a systematic review and meta-analysis.es_PE
dc.typeinfo:eu-repo/semantics/articlees_PE
dc.identifier.journalInfection control and hospital epidemiology (Infect Control Hosp Epidemiol)es_PE
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