Clostridioides difficile infection and antibiotic prescription rates in the community: Explaining the gender gap

2020 ◽  
pp. 1-3
Author(s):  
Mariam Younas ◽  
Julie Royer ◽  
Sharon B. Weissman ◽  
Hana R. Winders ◽  
Sangita Dash ◽  
...  
Keyword(s):  
South Carolina ◽  
Gender Gap ◽  
Antibiotic Prescription ◽  
Population Based ◽  
Incidence Rates ◽  
Cross Sectional ◽  
Crude Incidence ◽  
Clostridioides Difficile ◽  
Clostridioides Difficile Infection ◽  
Prescription Rates

Abstract In this cross-sectional population-based study, women had significantly higher crude incidence rates of both community-associated Clostridioides difficile infection (CA-CDI) and ambulatory antibiotic prescriptions compared to men in South Carolina in 2015. After adjustments for antibiotic prescription rates, there was no difference in the incidence rates of CA-CDI between the genders.

scholarly journals 975. Clostridium difficile Infection and Antibiotic Prescription Rates in the Community: Explaining the Gender Gap

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S39-S39 ◽  
Author(s):  
Mariam Younas ◽  
Julie Royer ◽  
Hana Rac ◽  
Julie Ann Justo ◽  
P Brandon Bookstaver ◽  
...  
Keyword(s):  
South Carolina ◽  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Antibiotic Prescription ◽  
Age Groups ◽  
Incidence Rates ◽  
Age Group ◽  
Significant Difference ◽  
Prescription Rates ◽  
Carolina Population

Abstract Background Previous studies have reported higher incidence rates of community-associated Clostridium difficile infection (CA-CDI) in women than in men. This cross-sectional population-based study examines whether this difference in CA-CDI rates across genders is driven by or independent of antibiotic use. Methods Medicaid and State Employee Health Plan pharmacy claims for outpatient oral antibiotics and associated medical claims were utilized for estimation of community antibiotic prescription rates in South Carolina population 18 to 64 years of age from January 1, 2015 to December 31, 2015. CA-CDI cases were identified from National Healthcare Safety Network (NHSN) and South Carolina Infectious Disease and Outbreak Network (SCION) through complete enumeration of South Carolina population of the same age and study period as above. Incidence rates of CA-CDI were reported in both men and women 18–39 and 40–64 years of age before and after adjustments for antibiotic prescription rates in the same gender and age group. The 95% confidence intervals (CI) were calculated to examine statistical difference in incidence rates across genders within the same age group. Results During the calendar year 2015, a total of 1,564 CA-CDI cases were identified in South Carolina residents 18–64 years of age. The incidence rate of CA-CDI per 100,000 person-years was higher in women than in men in age groups 18–39 years (37.3 [95% CI: 32.8–41.8] vs. 21.0 [95% CI: 17.6–24.4]) and 40–64 years (86.4 [95% CI: 80.1–92.8] vs. 56.6 [95% CI: 51.2–61.9]. Similarly, antibiotic prescription rates per 100 person-years were higher in women than men in the 2 respective age groups (118.8 [95% CI: 118.3–119.3] vs. 54.3 [95% CI: 53.9–54.8] and 130.4 [95% CI: 129.8–130.9] vs. 83.8 [95% CI: 83.3–84.4]. After adjustments for antibiotic prescriptions, there was no significant difference in the incidence rates of CA-CDI per 100,000 prescriptions between women and men 18–39 years of age (31.4 [95% CI: 27.6–35.2] vs. 38.6 [95% CI: 32.4–44.8] and 40–64 years old (66.3 [95% CI 61.5–71.2] vs. 67.5 [95% CI: 61.1–73.8]). Conclusion Higher crude incidence rates of CA-CDI in women are likely due to higher outpatient antibiotic prescription rates in women when compared with men. Disclosures P. B. Bookstaver, CutisPharma: Scientific Advisor, <$1,000. Melinta Therapeutics: Speaker’s Bureau, <$1,000.

scholarly journals Analysis of National Healthcare Safety Network Clostridioides difficile Infection Standardized Infection Ratio by Test Type

2020 ◽  
Vol 41 (S1) ◽  
pp. s116-s118
Author(s):  
Qunna Li ◽  
Andrea Benin ◽  
Alice Guh ◽  
Margaret A. Dudeck ◽  
Katherine Allen-Bridson ◽  
...  
Keyword(s):  
Risk Adjustment ◽  
Healthcare Facility ◽  
Directional Pattern ◽  
Incidence Rates ◽  
Nucleic Acid Amplification ◽  
Test Type ◽  
Clostridioides Difficile ◽  
Clostridioides Difficile Infection ◽  
The Mean ◽  
The Difference

Background: The NHSN has used positive laboratory tests for surveillance of Clostridioides difficile infection (CDI) LabID events since 2009. Typically, CDIs are detected using enzyme immunoassays (EIAs), nucleic acid amplification tests (NAATs), or various test combinations. The NHSN uses a risk-adjusted, standardized infection ratio (SIR) to assess healthcare facility-onset (HO) CDI. Despite including test type in the risk adjustment, some hospital personnel and other stakeholders are concerned that NAAT use is associated with higher SIRs than are EIAs. To investigate this issue, we analyzed NHSN data from acute-care hospitals for July 1, 2017 through June 30, 2018. Methods: Calendar quarters for which CDI test type was reported as NAAT (includes NAAT, glutamate dehydrogenase (GDH)+NAAT and GDH+EIA followed by NAAT if discrepant) or EIA (includes EIA and GDH+EIA) were selected. HO CDI SIRs were calculated for facility-wide inpatient locations. We conducted the following analyses: (1) Among hospitals that did not switch their test type, we compared the distribution of HO incident rates and SIRs by those reporting NAAT vs EIA. (2) Among hospitals that switched their test type, we selected quarters with a stable switch pattern of 2 consecutive quarters of each of EIA and NAAT (categorized as pattern EIA-to-NAAT or NAAT-to-EIA). Pooled semiannual SIRs for EIA and NAAT were calculated, and a paired t test was used to evaluate the difference of SIRs by switch pattern. Results: Most hospitals did not switch test types (3,242, 89%), and 2,872 (89%) reported sufficient data to calculate SIRs, with 2,444 (85%) using NAAT. The crude pooled HO CDI incidence rates for hospitals using EIA clustered at the lower end of the histogram versus rates for NAAT (Fig. 1). The SIR distributions of both NAAT and EIA overlapped substantially and covered a similar range of SIR values (Fig. 1). Among hospitals with a switch pattern, hospitals were equally likely to have an increase or decrease in their SIR (Fig. 2). The mean SIR difference for the 42 hospitals switching from EIA to NAAT was 0.048 (95% CI, −0.189 to 0.284; P = .688). The mean SIR difference for the 26 hospitals switching from NAAT to EIA was 0.162 (95% CI, −0.048 to 0.371; P = .124). Conclusions: The pattern of SIR distributions of both NAAT and EIA substantiate the soundness of NHSN risk adjustment for CDI test types. Switching test type did not produce a consistent directional pattern in SIR that was statistically significant.Disclosures: NoneFunding: None

scholarly journals Incidence of outbreak-associated COVID-19 cases by industry in Ontario, Canada, April 1, 2020- March 31, 2021

2021 ◽  
Author(s):  
Sarah A Buchan ◽  
Peter M Smith ◽  
Christine Warren ◽  
Michelle Murti ◽  
Cameron Mustard ◽  
...  
Keyword(s):  
Labour Force ◽  
Population Based ◽  
Cross Sectional Study ◽  
Incidence Rates ◽  
American Industry ◽  
Cross Sectional ◽  
Market Participants ◽  
Working Age ◽  
Time Periods ◽  
Statistics Canada

Objectives The objective of our study was to estimate the rate of workplace outbreak-associated cases of COVID-19 by industry in labour market participants aged 15-69 years who reported working the majority of hours outside the home in Ontario, Canada. Methods We conducted a population based cross-sectional study of COVID-19 workplace outbreaks and associated-cases reported in Ontario between April 1, 2020 and March 31, 2021. All outbreaks were manually classified into two digit North American Industry Classification System (NAICS) codes. We obtained denominator data from the Statistics Canada Labour Force Survey in order to estimate the incidence of outbreak-associated cases per 100,000,000 hours amongst individuals who reported the majority of hours were worked outside the home. We performed this analysis across industries and in three distinct time periods. Results Overall, 12% of cases were attributed to workplace outbreaks among working age adults across our study period. While incidence varied across the time periods, the five industries with the highest incidence rates across our study period were agriculture; healthcare and social assistance; food manufacturing; educational services; and, transportation and warehousing. Conclusions Certain industries have consistently increased incidence of COVID-19 over the course of the pandemic. These results may assist in ongoing efforts to reduce transmission of COVID-19, by prioritizing resources, as well as industry-specific guidance, vaccination, and public health messaging.

Temporal trends in ambulatory antibiotic prescription rates in South Carolina: Impact of age, gender, and resident location

2020 ◽  
Vol 41 (8) ◽  
pp. 879-882
Author(s):  
Hana R. Winders ◽  
Julie Royer ◽  
Mariam Younas ◽  
Julie Ann Justo ◽  
P. Brandon Bookstaver ◽  
...  
Keyword(s):  
South Carolina ◽  
Rural Areas ◽  
Urban Areas ◽  
Antibiotic Prescription ◽  
Temporal Trends ◽  
Age Groups ◽  
Winter Season ◽  
Ambulatory Setting ◽  
Oral Antibiotic ◽  
Prescription Rates

AbstractObjective:To examine the temporal trends in ambulatory antibiotic prescription fill rates and to determine the influences of age, gender, and location.Design:Population-based cohort study.Setting:Ambulatory setting in South Carolina.Patients:Patients ≤64 years of age from January 2012 to December 2017.Methods:Aggregated pharmacy claims data for oral antibiotic prescriptions were utilized to estimate community antibiotic prescription rates. Poisson regression or Student t tests were used to examine overall temporal trend in antibiotic prescription rates, seasonal variation, and the trends across age group, gender, and rural versus urban location.Results:Overall antibiotic prescription rates decrease from 1,127 to 897 per 1,000 person years (P < .001). The decrease was more noticeable in persons aged <18 years (26%) and 18–39 years (20%) than in those aged 40–64 years (5%; P < .001 for all). Prescription rates were higher among females than males in all age groups, although this finding was the most pronounced in group aged 18–39 years (1,232 vs 585 per 1,000 person years; P < .0001). Annualized antibiotic prescription rates were higher during the winter months (December–March) than the rest of the year (1,145 vs 885 per 1,000 person years; P < .0001), and rates were higher in rural areas than in urban areas (1,032 vs 941 per 1,000 person years; P < .0001).Conclusions:The decline in ambulatory antibiotic prescription rates is encouraging. Ongoing ambulatory antibiotic stewardship efforts across South Carolina should focus on older adults, rural areas, and during the winter season when antibiotic prescriptions peak.

Burden of community-associated Clostridioides difficile infection in southeastern United States: a population-based study

Infection ◽  
2019 ◽  
Vol 48 (1) ◽  
pp. 129-132 ◽  
Author(s):  
Mariam Younas ◽  
Julie Royer ◽  
Sharon B. Weissman ◽  
Katie S. Waites ◽  
Sangita Dash ◽  
...  
Keyword(s):  
United States ◽  
Southeastern United States ◽  
Population Based ◽  
Population Based Study ◽  
Clostridioides Difficile ◽  
Clostridioides Difficile Infection

Prostate cancer incidence and predictions: Observational Study (Monastir, Tunisia: 2002-2030)

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
R Bannour ◽  
I Zemni ◽  
C Ben Nasrallah ◽  
N Aroua ◽  
M Kacem ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Incidence ◽  
Cancer Registries ◽  
Population Based ◽  
Incidence Rates ◽  
Cancer Site ◽  
International Agency ◽  
Crude Incidence ◽  
The Future ◽  
Spss Software

Abstract Introduction Cancer is an eminent public health issue in the developing countries. The risk factors incriminated in cancer higher incidence are multiple such as the growing population rates, increasing tobacco consumption, the changes of diet and lifestyle. In Tunisia, there are three population-based cancer registries at the present time providing data on cancer incidence and survival. According to the data published by WHO International Agency for Research on Cancer (IACR) (GLOBOCAN 2018), prostate cancer in Tunisia ranks fifth among cancers with almost 819 new cases per year. The aim of this study was to we report trends in the cancer incidence during the span of time between 2002 and 2013 from the population-based cancer registry of the centre of Tunisia, and to predict the future number of cancer cases by 2030. Methods The cancer incidence data were collected from the Center cancer registries from 2003 to 2012.The data were stratified by cancer site, sex and age. We used SPSS software in order to calculate the crude incidence rates and age-standardized incidence rates. SPSS software was used in order to estimate the future number of cancer cases by 2030. Results A total of 725 cases of prostate cancer were enregistrated. The mean age of patients was 71.6 ±10.61years. The crude incidence rates were estimated 23.537. The standardized incidence rate was 33.92. A significant positive trend was noted with a b = 0133 and p &lt; 10-3. 1033 new cases are predicted by 2030 Conclusions The data of the cancer register of the center shows that the incidence of cancer is rising, and it is consistent with the National cancer intelligence, but some cancer incidence showed slightly higher, such as thyroid cancer and prostate cancer. In order to face this alarming situation, many preventive steps should be done such as strengthening early screening and diagnosis of cancer, improving clinical research in order to better control the risks factors. Key messages Prediction of the future number of cancer cases is of great interest to society. Prostate cancer in Tunisia ranks fifth among cancers.

scholarly journals Correlation of prevention practices with rates of health care-associated Clostridioides difficile infection

2019 ◽  
Vol 41 (1) ◽  
pp. 52-58
Author(s):  
Jackson S. Musuuza ◽  
Linda McKinley ◽  
Julie A. Keating ◽  
Chidi Obasi ◽  
Mary Jo Knobloch ◽  
...  
Keyword(s):  
Healthcare Facility ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Electronic Survey ◽  
Contact Precautions ◽  
Clostridioides Difficile ◽  
Increased Risk ◽  
Clostridioides Difficile Infection ◽  
Bed Days ◽  
Acute Care Facilities

AbstractObjective:We examined Clostridioides difficile infection (CDI) prevention practices and their relationship with hospital-onset healthcare facility-associated CDI rates (CDI rates) in Veterans Affairs (VA) acute-care facilities.Design:Cross-sectional study.Methods:From January 2017 to February 2017, we conducted an electronic survey of CDI prevention practices and hospital characteristics in the VA. We linked survey data with CDI rate data for the period January 2015 to December 2016. We stratified facilities according to whether their overall CDI rate per 10,000 bed days of care was above or below the national VA mean CDI rate. We examined whether specific CDI prevention practices were associated with an increased risk of a CDI rate above the national VA mean CDI rate.Results:All 126 facilities responded (100% response rate). Since implementing CDI prevention practices in July 2012, 60 of 123 facilities (49%) reported a decrease in CDI rates; 22 of 123 facilities (18%) reported an increase, and 41 of 123 (33%) reported no change. Facilities reporting an increase in the CDI rate (vs those reporting a decrease) after implementing prevention practices were 2.54 times more likely to have CDI rates that were above the national mean CDI rate. Whether a facility’s CDI rates were above or below the national mean CDI rate was not associated with self-reported cleaning practices, duration of contact precautions, availability of private rooms, or certification of infection preventionists in infection prevention.Conclusions:We found considerable variation in CDI rates. We were unable to identify which particular CDI prevention practices (i.e., bundle components) were associated with lower CDI rates.

scholarly journals Antibiotic use for typhoid in India: Estimation from private sector prescription data during 2013-15

2021 ◽  
Author(s):  
Shaffi Fazaludeen Koya ◽  
Habib Hasan Farooqui ◽  
Aashna Mehta ◽  
Sakthivel Selvaraj ◽  
Sandro Galea
Keyword(s):  
Private Sector ◽  
Disease Surveillance ◽  
Primary Care Physicians ◽  
Antibiotic Prescription ◽  
Antibiotic Use ◽  
Population Based ◽  
Prescription Data ◽  
Adult Age ◽  
Disease Surveillance System ◽  
Prescription Rates

Background India's typhoid burden estimates are based on a limited number of population-based studies and data from a grossly incomplete disease surveillance system. In this study, we estimated the total and sex-and age-specific antibiotic prescription rates for typhoid. Methods We used systematic antibiotic prescription by private sector primary care physicians in India. We categorized antibiotics using the WHO classification system and calculated the prescription for various classes of antibiotics. Results We analyzed 671 million prescriptions for the three-year period (2013-2015), of which an average of 8.98 million antibiotic prescriptions per year was for typhoid, accounting for 714 prescriptions per 100,000 population. Combination antibiotics are the preferred choice of prescribers in the adult age group, while cephalosporins are the preferred choice in children and young age. The prescription rate decreased from 792/100,000 in 2013 to 635 in 2015. Conclusion We report a higher rate of antibiotic prescription for typhoid using prescription data, indicating a higher disease burden than previously estimated. Quinolones are still widely used in monotherapy, and children less than 10 years account for more than a million cases annually, which calls for a routine vaccination program.

scholarly journals Incidence of outbreak-associated COVID-19 cases by industry in Ontario, Canada, 1 April 2020–31 March 2021

2022 ◽  
pp. oemed-2021-107879
Author(s):  
Sarah A Buchan ◽  
Peter M Smith ◽  
Christine Warren ◽  
Michelle Murti ◽  
Cameron Mustard ◽  
...  
Keyword(s):  
Labour Force ◽  
Population Based ◽  
Cross Sectional Study ◽  
Incidence Rates ◽  
American Industry ◽  
Cross Sectional ◽  
Market Participants ◽  
Working Age ◽  
Time Periods ◽  
Statistics Canada

ObjectivesThe objective of our study was to estimate the rate of workplace outbreak-associated cases of COVID-19 by industry in labour market participants aged 15–69 years who reported working the majority of hours outside the home in Ontario, Canada.MethodsWe conducted a population-based cross-sectional study of COVID-19 workplace outbreaks and associated cases reported in Ontario between 1 April 2020 and 31 March 2021. All outbreaks were manually classified into two-digit North American Industry Classification System codes. We obtained monthly denominator estimates from the Statistics Canada Labour Force Survey to estimate the incidence of outbreak-associated cases per 100 000 000 hours among individuals who reported the majority of hours were worked outside the home. We performed this analysis across industries and in three distinct time periods.ResultsOverall, 12% of cases were attributed to workplace outbreaks among working-age adults across our study period. While incidence varied across the time periods, the five industries with the highest incidence rates across our study period were agriculture, healthcare and social assistance, food manufacturing, educational services, and transportation and warehousing.ConclusionsCertain industries have consistently increased the incidence of COVID-19 over the course of the pandemic. These results may assist in ongoing efforts to reduce transmission of COVID-19 by prioritising resources, as well as industry-specific guidance, vaccination and public health messaging.

scholarly journals Understanding the gender gap in antibiotic prescribing: a cross-sectional analysis of English primary care

BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e020203 ◽  
Author(s):  
David R M Smith ◽  
F Christiaan K Dolk ◽  
Timo Smieszek ◽  
Julie V Robotham ◽  
Koen B Pouwels
Keyword(s):  
Primary Care ◽  
Tract Infection ◽  
Gender Gap ◽  
Antibiotic Prescription ◽  
The Elderly ◽  
Antibiotic Prescribing ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
Sectional Analysis ◽  
To Receive

ObjectivesTo explore the causes of the gender gap in antibiotic prescribing, and to determine whether women are more likely than men to receive an antibiotic prescription per consultation.DesignCross-sectional analysis of routinely collected electronic medical records from The Health Improvement Network (THIN).SettingEnglish primary care.ParticipantsPatients who consulted general practices registered with THIN between 2013 and 2015.Primary and secondary outcome measuresTotal antibiotic prescribing was measured in children (<19 years), adults (19–64 years) and the elderly (65+ years). For 12 common conditions, the number of adult consultations was measured, and the relative risk (RR) of being prescribed antibiotics when consulting as female or with comorbidity was estimated.ResultsAmong 4.57 million antibiotic prescriptions observed in the data, female patients received 67% more prescriptions than male patients, and 43% more when excluding antibiotics used to treat urinary tract infection (UTI). These gaps were more pronounced in adult women (99% more prescriptions than men; 69% more when excluding UTI) than in children (9%; 0%) or the elderly (67%; 38%). Among adults, women accounted for 64% of consultations (62% among patients with comorbidity), but were not substantially more likely than men to receive an antibiotic prescription when consulting with common conditions such as cough (RR 1.01; 95% CI 1.00 to 1.02), sore throat (RR 1.01, 95% CI 1.00 to 1.01) and lower respiratory tract infection (RR 1.00, 95% CI 1.00 to 1.01). Exceptions were skin conditions: women were less likely to be prescribed antibiotics when consulting with acne (RR 0.67, 95% CI 0.66 to 0.69) or impetigo (RR 0.85, 95% CI 0.81 to 0.88).ConclusionsThe gender gap in antibiotic prescribing can largely be explained by consultation behaviour. Although in most cases adult men and women are equally likely to be prescribed an antibiotic when consulting primary care, it is unclear whether or not they are equally indicated for antibiotic therapy.

Sign in / Sign up

Export Citation Format

Share Document