Risk factors for recurrent Clostridium difficile infection: a systematic review and meta-analysis.
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Authors
Deshpande, AbhishekPasupuleti, Vinay
Thota, Priyaleela
Pant, Chaitanya
Rolston, David D K
Hernandez, Adrian V.
Donskey, Curtis J
Fraser, Thomas G
Issue Date
2015-04MeSH
Clostridium difficileEnterocolitis, Pseudomembranous
Humans
Recurrence
Risk Factors
Metadata
Show full item recordCitation
Risk factors for recurrent Clostridium difficile infection: a systematic review and meta-analysis. 2015, 36 (4):452-60 Infect Control Hosp EpidemiolPublisher
Cambridge University PressJournal
Infection control and hospital epidemiology (Infect Control Hosp Epidemiol)DOI
10.1017/ice.2014.88PubMed ID
25626326Additional Links
http://www.ncbi.nlm.nih.gov/pubmed/25626326Abstract
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/articleRights
info:eu-repo/semantics/openAccessLanguage
engDescription
El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado.ISSN
1559-6834ae974a485f413a2113503eed53cd6c53
10.1017/ice.2014.88
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