Quinolone Use as a Risk Factor for Nosocomial Clostridium difficile-Associated Diarrhea

2001 ◽  
Vol 22 (9) ◽  
pp. 572-575 ◽  
Author(s):  
Clarwyn Yip ◽  
Mark Loeb ◽  
Suzette Salama ◽  
Lorraine Moss ◽  
Jan Olde
Keyword(s):  
Risk Factors ◽  
Clostridium Difficile ◽  
Conditional Logistic Regression ◽  
Demographic Data ◽  
Tertiary Care ◽  
Care Hospital ◽  
Final Model ◽  
Clostridium Difficile Associated Diarrhea ◽  
And Control ◽  
Control Study

AbstractObjective:To determine modifiable risk factors for nosocomial Clostridium difficile-associated diarrhea (CDAD).Design:Case-control study.Setting:300-bed tertiary-care hospital.Participants:Hospital inpatients present during the 3-month study period.Methods:Case-patients identified with nosocomial CDAD over the study period were compared to two sets of control patients: inpatients matched by age, gender, and date of admission; and inpatients matched by duration of hospital stay. Variables including demographic data, comorbid illnesses, antibiotic exposure, and use of gastrointestinal medications were assessed for case- and control-patients. Conditional logistic regression was performed to identify risk factors for nosocomial CDAD.Results:27 case-patients were identified and were compared to the two sets of controls (1:1 match for each comparison set). For the first set of controls, use of ciprofloxacin (odds ratio [OR], 5.5; 95% confidence interval [CI95], 1.2-24.8; P=.03) was the only variable that remained significant in the multivariable model. For the second set of controls, prior exposure to cephalosporins (OR, 6.7; CL,5, 1.3-33.7; P=.02) and to ciprofloxacin (OR, 9.5; CI95, 1.01-88.4; P=.05) were kept in the final model.Conclusions:Along with cephalosporins, prior quinolone use predisposed hospitalized patients to nosocomial CDAD. Quinolones should be used judiciously in acute-care hospitals, particularly in those where CDAD is endemic.

scholarly journals Risk Factors for Clostridium Difficile Infection in a Tertiary Care Hospital

2018 ◽  
Vol 3 (3) ◽  
pp. 124
Author(s):  
Muralidhar Varma ◽  
Neha Agrawal ◽  
Pallavi Uppal ◽  
Rahul Singh ◽  
Karunya Jayasimha ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clostridium Difficile ◽  
Case Control Study ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Significant Risk ◽  
Care Hospital ◽  
The Past ◽  
Appropriate Treatment ◽  
Control Study

Introduction: Clostridium difficile infections have had significant morbidity and mortality in the last decade leading to high healthcare costs. Our prospective case-control study from October 2013 to May 2015 in a tertiary care hospital in rural India aimed to evaluate the risk factors, treatment, outcome, and complications of Clostridium difficile infections in hospitalized patients.Materials and Methods: The study involved a total of 183 patients, of which 61 were cases, and 122 were controls. Data was analyzed using multivariate logistic regression.Results: Antibiotic intake in the past four weeks (p=0.003), hypoalbuminemia (p=0.001) and duration of hospital stay before the onset of diarrhea (p<0.001) were proven to have significant risk. We subdivided cases into severe and non-severe cases, and we found that complications were statistically higher in severe cases (OR= 1.685, <0.001).Conclusion: Identifying severe cases and administering timely and appropriate treatment is prudent.

scholarly journals Risk Factors for Acquisition of Clostridium difficile–Associated Diarrhea among Outpatients at a Cancer Hospital

2005 ◽  
Vol 26 (8) ◽  
pp. 680-684 ◽  
Author(s):  
Tara N. Palmore ◽  
SeJean Sohn ◽  
Sharp F. Malak ◽  
Janet Eagan ◽  
Kent A Sepkowitz
Keyword(s):  
Risk Factors ◽  
Clostridium Difficile ◽  
Case Control Study ◽  
Tertiary Care ◽  
Antibiotic Use ◽  
Generation Cephalosporin ◽  
Case Control ◽  
Cancer Center ◽  
Care Hospital ◽  
Control Study

AbstractBackground:Clostridium difficile-associated diarrhea (CDAD) is an important infection in hospital settings. Its impact on outpatient care has not been well defined.Objective:To examine risk factors of ambulatory cancer patients with CDAD.Design:Case-control study.Setting:Memorial Sloan-Kettering Cancer Center, a tertiary-care hospital.Methods:Cases of CDAD among oncology outpatients from January 1999 through December 2000 were identified via positive C. difficile toxin assay results on stool specimens sent from clinics or the emergency department. A 1:3 matched case-control study examined exposures associated with CDAD.Results:Forty-eight episodes of CDAD were identified in cancer outpatients. The mean age was 51 years; 44% were female. Forty-one (85%) had received antibiotics within 60 days of diagnosis, completing courses a median of 16.5 days prior to diagnosis. Case-patients received longer courses of first-generation cephalosporins (4.8 vs 3.2 days; P = .03) and fluoroquinolones (23.6 vs 8 days; P < .01) than did control-patients. Those receiving clindamycin were 3.9-fold more likely to develop CDAD (P < .01). For each additional day of clindamycin or third-generation cephalosporin exposure, patients were 1.29- and 1.26-fold more likely to develop CDAD (P < .01 and .04, respectively). The 38 CDAD patients hospitalized during the risk period (79.2%) spent more time as inpatients than did control-patients (19.3 vs 9.7 days; P <. 001).Conclusions:Antibiotic use, especially with cephalosporins and clindamycin, and prolonged hospitalization contributed to the development of CDAD. Outpatient CDAD appears to be most strongly related to inpatient exposures; reasons for the delayed development of symptoms are unknown.

S1229 Risk Factors for Recurrent Clostridium difficile-Associated Diarrhea: A Retrospective Case-Control Study

2010 ◽  
Vol 138 (5) ◽  
pp. S-209
Author(s):  
Nabeel Koro ◽  
Yazan Abdalla ◽  
Fasiha Kanwal ◽  
Jay R. McDonald ◽  
Angelique L. Zeringue ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clostridium Difficile ◽  
Case Control Study ◽  
Case Control ◽  
Retrospective Case ◽  
Clostridium Difficile Associated Diarrhea ◽  
Control Study

scholarly journals Risk factors for bleeding in haemato-oncology patients—a nested case–control study: The BITE study protocol (Bleeding In Thrombocytopenia Explained)

BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e034710 ◽  
Author(s):  
Loes L Cornelissen ◽  
Camila Caram-Deelder ◽  
Johanna G van der Bom ◽  
Rutger A Middelburg ◽  
Jaap Jan Zwaginga
Keyword(s):  
Risk Factors ◽  
Case Control Study ◽  
Conditional Logistic Regression ◽  
Case Control ◽  
Source Population ◽  
Bleeding Events ◽  
Oncological Patients ◽  
Nested Case Control ◽  
And Control ◽  
Control Study

IntroductionHaemato-oncological patients often receive platelet count driven prophylactic platelet transfusions to prevent bleeding. However, many prophylactically transfused patients still bleed. More knowledge on risk factors for bleeding is therefore needed. This will enable identification of bleeding risk profiles on which future transfusion policy can be optimised. The present BITE study (Bleeding In Thrombocytopenia Explained) aims to identify clinical conditions and biomarkers that are associated with clinically relevant bleeding events.Methods and analysisA matched case–control study nested in a cohort of haemato-oncological patients in the Netherlands. We collect a limited number of variables from all eligible patients, who together form the source population. These patients are followed for the occurrence of clinically relevant bleeding. Consenting patients of the source population form the cohort. Cases from the cohort are frequency matched to selected control patients for the nested case–control study. Of both case and control patients more detailed clinical data is collected.Study populationAdult haemato-oncological patients, who are admitted for intensive chemotherapeutic treatment or stem cell transplantation, or who received such treatments in the past and are readmitted for disease or treatment-related adverse events.Statistical analysisBleeding incidences will be calculated for the total source population, as well as for different subgroups. The association between potential risk factors and the occurrence of bleeding will be analysed using conditional logistic regression, to account for matching of case and control patients.Ethics and disseminationThe study was approved by the Medical Research Ethics Committee Leiden Den Haag and Delft, and the Radboudumc Committee on Research Involving Human Subjects. Approval in seven other centres is foreseen. Patients will be asked for written informed consent and data is coded before analyses, according to Dutch privacy law. Results will be published in peer-reviewed journals.Trial registration numberNL62499.058.17. NCT03505086; Pre-results.

scholarly journals Socio-demographic Status & Associated Risk Factors of the Stroke Patient's in a Tertiary Care Hospital of Bangladesh

2013 ◽  
Vol 4 (2) ◽  
pp. 18-22 ◽  
Author(s):  
Mahmudur Rahman Siddiqui ◽  
Quazi Tarikul Islam ◽  
Md. Jabed Iqbal ◽  
Sumaiya Sultana Binte-Mosharraf
Keyword(s):  
Risk Factors ◽  
Acute Stroke ◽  
Low Income ◽  
Demographic Data ◽  
Tertiary Care ◽  
Income Group ◽  
Care Hospital ◽  
Stroke Patients ◽  
College Hospital ◽  
Medical College

Stroke is the most common neurological emergency. A total number of 100 randomly selected, clinically and CT proven acute stroke patients were studied at medicine units of Dhaka Medical College Hospital. Socio-demographic data and major risk factors or co-morbid conditions among acute stroke patient were identified and correlated. Out of 100 patients 29% were in between 51- 60 years age group & 72% were male and 28% were female patients. In this series 24% were illiterate. Of the literate group 39% went to primary school, 20% completed SSC, 8% completed HSC, 5% completed graduation and only 4% completed post-graduation. Majority of the patients were unemployed (22%). Other was businessman (20%), housewife (19%) and cultivator (16%). 63% percentage of the patients from low income group, which was followed by middle income group (33%). Majority 53% patients had Ischaemic stroke, 45% Intracerebral haemorrhage (ICH) and only 2% had Subarachnoid haemorrhage (SAH). 77% of patient had history of hypertension, 22% Diabetes mellitus, 20% Dyslipidaemia, 13% Previous Stroke, 27% Ischaemic heart disease. Out of 77 hypertensive stroke patients 37(48.05%) had haemorrhagic stroke & 40(51.94%) had ischemic stroke. Anwer Khan Modern Medical College Journal Vol. 4, No. 2: July 2013, Pages 18-22 DOI: http://dx.doi.org/10.3329/akmmcj.v4i2.16920

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