Impact of Clostridium difficile infection among pneumonia and urinary tract infection hospitalizations: an analysis of the Nationwide Inpatient Sample

doi:10.1186/s12879-015-0925-9

. 2015 Jul 1:15:254.

doi: 10.1186/s12879-015-0925-9.

Impact of Clostridium difficile infection among pneumonia and urinary tract infection hospitalizations: an analysis of the Nationwide Inpatient Sample

Monideepa B Becerra^{1

2

3}, Benjamin J Becerra^{4

5}, Jim E Banta⁶, Nasia Safdar^{7

8}

Affiliations

¹ Department of Health Science and Human Ecology, California State University, San Bernardino, USA. mbecerra@csusb.edu.
² William S Middleton Memorial Veterans Hospital, Madison, Wisconsin, USA. mbecerra@csusb.edu.
³ Primary Address: 5500 University Parkway, San Bernardino, CA, 92407, USA. mbecerra@csusb.edu.
⁴ William S Middleton Memorial Veterans Hospital, Madison, Wisconsin, USA. bbecerra@llu.edu.
⁵ School of Public Health, Loma Linda University, Primary Address: 24951 North Circle Drive, Loma Linda, CA, 92350, USA. bbecerra@llu.edu.
⁶ School of Public Health, Loma Linda University, Primary Address: 24951 North Circle Drive, Loma Linda, CA, 92350, USA. jbanta@llu.edu.
⁷ William S Middleton Memorial Veterans Hospital, Madison, Wisconsin, USA. Ns2@medicine.wisc.edu.
⁸ University of Wisconsin, Primary Address: 1685 Highland Ave., Madison, Wisconsin, 53705, USA. Ns2@medicine.wisc.edu.

PMID: 26126606
PMCID: PMC4487835
DOI: 10.1186/s12879-015-0925-9

Impact of Clostridium difficile infection among pneumonia and urinary tract infection hospitalizations: an analysis of the Nationwide Inpatient Sample

Monideepa B Becerra et al. BMC Infect Dis. 2015.

. 2015 Jul 1:15:254.

doi: 10.1186/s12879-015-0925-9.

Authors

Monideepa B Becerra^{1

2

3}, Benjamin J Becerra^{4

5}, Jim E Banta⁶, Nasia Safdar^{7

8}

Affiliations

¹ Department of Health Science and Human Ecology, California State University, San Bernardino, USA. mbecerra@csusb.edu.
² William S Middleton Memorial Veterans Hospital, Madison, Wisconsin, USA. mbecerra@csusb.edu.
³ Primary Address: 5500 University Parkway, San Bernardino, CA, 92407, USA. mbecerra@csusb.edu.
⁴ William S Middleton Memorial Veterans Hospital, Madison, Wisconsin, USA. bbecerra@llu.edu.
⁵ School of Public Health, Loma Linda University, Primary Address: 24951 North Circle Drive, Loma Linda, CA, 92350, USA. bbecerra@llu.edu.
⁶ School of Public Health, Loma Linda University, Primary Address: 24951 North Circle Drive, Loma Linda, CA, 92350, USA. jbanta@llu.edu.
⁷ William S Middleton Memorial Veterans Hospital, Madison, Wisconsin, USA. Ns2@medicine.wisc.edu.
⁸ University of Wisconsin, Primary Address: 1685 Highland Ave., Madison, Wisconsin, 53705, USA. Ns2@medicine.wisc.edu.

PMID: 26126606
PMCID: PMC4487835
DOI: 10.1186/s12879-015-0925-9

Abstract

Background: Clostridium difficile infection (CDI) remains one of the major hospital acquired infections in the nation, often attributable to increased antibiotic use. Little research, however, exists on the prevalence and impact of CDI on patient and hospital outcomes among populations requiring such treatment. As such, the goal of this study was to examine the prevalence, risk factors, and impact of CDI among pneumonia and urinary tract infection (UTI) hospitalizations.

Methods: The Nationwide Inpatient Sample (2009-2011), reflecting a 20% stratified sample of community hospitals in the United States, was used. A total of 593,038 pneumonia and 255,770 UTI discharges were included. Survey-weighted multivariable regression analyses were conducted to assess the predictors and impact of CDI among pneumonia and UTI discharges.

Results: A significantly higher prevalence of CDI was present among men with UTI (13.3 per 1,000) as compared to women (11.3 per 1,000). CDI was associated with higher in-hospital mortality among discharges for pneumonia (adjusted odds ratio [aOR] for men = 3.2, women aOR = 2.8) and UTI (aOR for men = 4.1, women aOR = 3.4). Length of stay among pneumonia and UTI discharges were also double upon presence of CDI. In addition, CDI increased the total charges by at least 75% and 55% among pneumonia and UTI discharges, respectively. Patient and hospital characteristics associated with CDI included being 65 years or older, Charlson Deyo index for comorbidity of 2 or more, Medicare as the primary payer, and discharge from urban hospitals, among both pneumonia and UTI discharges.

Conclusion: CDI occurs frequently in hospitalizations among those discharged from hospital for pneumonia and UTI, and is associated with increased in-hospital mortality and health resource utilization. Interventions to mitigate the burden of CDI in these high-risk populations are urgently needed.

PubMed Disclaimer

Cited by

Evaluation of point-of-care multiplex polymerase chain reaction in guiding antibiotic treatment of patients acutely admitted with suspected community-acquired pneumonia in Denmark: A multicentre randomised controlled trial.
Cartuliares MB, Rosenvinge FS, Mogensen CB, Skovsted TA, Andersen SL, Østergaard C, Pedersen AK, Skjøt-Arkil H. Cartuliares MB, et al. PLoS Med. 2023 Nov 28;20(11):e1004314. doi: 10.1371/journal.pmed.1004314. eCollection 2023 Nov. PLoS Med. 2023. PMID: 38015833 Free PMC article. Clinical Trial.
Identify Drug-Resistant Pathogens in Patients with Community-Acquired Pneumonia.
Amati F, Bindo F, Stainer A, Gramegna A, Mantero M, Nigro M, Bussini L, Bartoletti M, Blasi F, Aliberti S. Amati F, et al. Adv Respir Med. 2023 May 31;91(3):224-238. doi: 10.3390/arm91030018. Adv Respir Med. 2023. PMID: 37366804 Free PMC article. Review.
Assessing the risk and disease burden of Clostridium difficile infection among patients with hospital-acquired pneumonia at a University Hospital in Central China.
Li C, Duan J, Liu S, Meng X, Fu C, Zeng C, Wu A. Li C, et al. Infection. 2017 Oct;45(5):621-628. doi: 10.1007/s15010-017-1024-1. Epub 2017 May 11. Infection. 2017. PMID: 28497295 Free PMC article.
Marijuana use and inpatient outcomes among hospitalized patients: analysis of the nationwide inpatient sample database.
Vin-Raviv N, Akinyemiju T, Meng Q, Sakhuja S, Hayward R. Vin-Raviv N, et al. Cancer Med. 2017 Jan;6(1):320-329. doi: 10.1002/cam4.968. Epub 2016 Nov 28. Cancer Med. 2017. PMID: 27891823 Free PMC article.
Evaluating the Effectiveness of an Antimicrobial Stewardship Program on Reducing the Incidence Rate of Healthcare-Associated Clostridium difficile Infection: A Non-Randomized, Stepped Wedge, Single-Site, Observational Study.
DiDiodato G, McArthur L. DiDiodato G, et al. PLoS One. 2016 Jun 16;11(6):e0157671. doi: 10.1371/journal.pone.0157671. eCollection 2016. PLoS One. 2016. PMID: 27309536 Free PMC article.

References

1. Miller BA, Chen LF, Sexton DJ, Anderson DJ. Comparison of the burdens of hospital-onset, healthcare facility-associated clostridium difficile infection and of healthcare-associated infection due to methicillin-resistant staphylococcus aureus in community hospitals. Infect Control Hosp Epidemiol Off J Soc Hosp Epidemiol Am. 2011;32(4):387–90. doi: 10.1086/659156. - DOI - PubMed
1. Lessa FC, Gould CV, McDonald LC. Current status of clostridium difficile infection epidemiology. Clin Infect Dis Off Publ Infect Dis Soc Am. 2012;55(Suppl 2):S65–70. doi: 10.1093/cid/cis319. - DOI - PMC - PubMed
1. Goudarzi M, Seyedjavadi SS, Goudarzi H, Mehdizadeh Aghdam E, Nazeri S. Clostridium difficile infection: epidemiology, pathogenesis, risk factors, and therapeutic options. Scientifica. 2014;2014 doi: 10.1155/2014/916826. - DOI - PMC - PubMed
1. Campbell RJ, Giljahn L, Machesky K, Cibulskas-White K, Lane LM, Porter K, et al. Clostridium difficile infection in Ohio hospitals and nursing homes during 2006. Infect Control Hosp Epidemiol Off J Soc Hosp Epidemiol Am. 2009;30(6):526–33. doi: 10.1086/597507. - DOI - PubMed
1. Yearsley KA, Gilby LJ, Ramadas AV, Kubiak EM, Fone DL, Allison MC. Proton pump inhibitor therapy is a risk factor for clostridium difficile-associated diarrhoea. Aliment Pharmacol Ther. 2006;24(4):613–9. doi: 10.1111/j.1365-2036.2006.03015.x. - DOI - PubMed

Publication types

Actions
Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

LinkOut - more resources

Full Text Sources
Other Literature Sources
- scite Smart Citations
Medical
- MedlinePlus Health Information
Research Materials
- NCI CPTC Antibody Characterization Program

[1] Miller BA, Chen LF, Sexton DJ, Anderson DJ. Comparison of the burdens of hospital-onset, healthcare facility-associated clostridium difficile infection and of healthcare-associated infection due to methicillin-resistant staphylococcus aureus in community hospitals. Infect Control Hosp Epidemiol Off J Soc Hosp Epidemiol Am. 2011;32(4):387–90. doi: 10.1086/659156. - DOI - PubMed

[2] Miller BA, Chen LF, Sexton DJ, Anderson DJ. Comparison of the burdens of hospital-onset, healthcare facility-associated clostridium difficile infection and of healthcare-associated infection due to methicillin-resistant staphylococcus aureus in community hospitals. Infect Control Hosp Epidemiol Off J Soc Hosp Epidemiol Am. 2011;32(4):387–90. doi: 10.1086/659156. - DOI - PubMed

[3] Lessa FC, Gould CV, McDonald LC. Current status of clostridium difficile infection epidemiology. Clin Infect Dis Off Publ Infect Dis Soc Am. 2012;55(Suppl 2):S65–70. doi: 10.1093/cid/cis319. - DOI - PMC - PubMed

[4] Lessa FC, Gould CV, McDonald LC. Current status of clostridium difficile infection epidemiology. Clin Infect Dis Off Publ Infect Dis Soc Am. 2012;55(Suppl 2):S65–70. doi: 10.1093/cid/cis319. - DOI - PMC - PubMed

[5] Goudarzi M, Seyedjavadi SS, Goudarzi H, Mehdizadeh Aghdam E, Nazeri S. Clostridium difficile infection: epidemiology, pathogenesis, risk factors, and therapeutic options. Scientifica. 2014;2014 doi: 10.1155/2014/916826. - DOI - PMC - PubMed

[6] Goudarzi M, Seyedjavadi SS, Goudarzi H, Mehdizadeh Aghdam E, Nazeri S. Clostridium difficile infection: epidemiology, pathogenesis, risk factors, and therapeutic options. Scientifica. 2014;2014 doi: 10.1155/2014/916826. - DOI - PMC - PubMed

[7] Campbell RJ, Giljahn L, Machesky K, Cibulskas-White K, Lane LM, Porter K, et al. Clostridium difficile infection in Ohio hospitals and nursing homes during 2006. Infect Control Hosp Epidemiol Off J Soc Hosp Epidemiol Am. 2009;30(6):526–33. doi: 10.1086/597507. - DOI - PubMed

[8] Campbell RJ, Giljahn L, Machesky K, Cibulskas-White K, Lane LM, Porter K, et al. Clostridium difficile infection in Ohio hospitals and nursing homes during 2006. Infect Control Hosp Epidemiol Off J Soc Hosp Epidemiol Am. 2009;30(6):526–33. doi: 10.1086/597507. - DOI - PubMed

[9] Yearsley KA, Gilby LJ, Ramadas AV, Kubiak EM, Fone DL, Allison MC. Proton pump inhibitor therapy is a risk factor for clostridium difficile-associated diarrhoea. Aliment Pharmacol Ther. 2006;24(4):613–9. doi: 10.1111/j.1365-2036.2006.03015.x. - DOI - PubMed

[10] Yearsley KA, Gilby LJ, Ramadas AV, Kubiak EM, Fone DL, Allison MC. Proton pump inhibitor therapy is a risk factor for clostridium difficile-associated diarrhoea. Aliment Pharmacol Ther. 2006;24(4):613–9. doi: 10.1111/j.1365-2036.2006.03015.x. - DOI - PubMed

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Impact of Clostridium difficile infection among pneumonia and urinary tract infection hospitalizations: an analysis of the Nationwide Inpatient Sample

Affiliations

Impact of Clostridium difficile infection among pneumonia and urinary tract infection hospitalizations: an analysis of the Nationwide Inpatient Sample

Authors

Affiliations

Abstract

Similar articles

Cited by

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical

Research Materials

Abstract

Similar articles

Cited by

References

Publication types

MeSH terms

Related information

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical

Research Materials