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Evidence of within-facility patient–patient Clostridiodes difficile infection spread across diverse settings
Previous studies have suggested that a hospital patient's risk of developing healthcare facility-onset (HCFO) Clostridioides difficile infections (CDIs) increases with the number of concurrent spatially proximate patients with CDI, termed CDI pressure. However, these studies were performed eith...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cambridge University Press
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9990401/ https://www.ncbi.nlm.nih.gov/pubmed/36502810 http://dx.doi.org/10.1017/S0950268822001893 |
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author | Justice, Samuel Sewell, Daniel K. Li, Haomin Miller, Aaron C. Polgreen, Philip M. |
author_facet | Justice, Samuel Sewell, Daniel K. Li, Haomin Miller, Aaron C. Polgreen, Philip M. |
author_sort | Justice, Samuel |
collection | PubMed |
description | Previous studies have suggested that a hospital patient's risk of developing healthcare facility-onset (HCFO) Clostridioides difficile infections (CDIs) increases with the number of concurrent spatially proximate patients with CDI, termed CDI pressure. However, these studies were performed either in a single institution or in a single state with a very coarse measure of concurrence. We conducted a retrospective case-control study involving over 17.5 million inpatient visits across 700 hospitals in eight US states. We built a weighted, directed network connecting overlapping inpatient visits to measure facility-level CDI pressure. We then matched HCFO-CDIs with non-CDI controls on facility, comorbidities and demographics and performed a conditional logistic regression to determine the odds of developing HCFO-CDI given the number of coincident patient visits with CDI. On average, cases' visits coincided with 9.2 CDI cases, which for an individual with an average length of stay corresponded to an estimated 17.7% (95% CI 12.9–22.7%) increase in the odds of acquiring HCFO-CDI compared to an inpatient visit without concurrent CDI cases or fully isolated from both direct and indirect risks from concurrent CDI cases. These results suggest that, either directly or indirectly, hospital patients with CDI lead to CDIs in non-infected patients with temporally overlapping visits. |
format | Online Article Text |
id | pubmed-9990401 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Cambridge University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-99904012023-03-08 Evidence of within-facility patient–patient Clostridiodes difficile infection spread across diverse settings Justice, Samuel Sewell, Daniel K. Li, Haomin Miller, Aaron C. Polgreen, Philip M. Epidemiol Infect Original Paper Previous studies have suggested that a hospital patient's risk of developing healthcare facility-onset (HCFO) Clostridioides difficile infections (CDIs) increases with the number of concurrent spatially proximate patients with CDI, termed CDI pressure. However, these studies were performed either in a single institution or in a single state with a very coarse measure of concurrence. We conducted a retrospective case-control study involving over 17.5 million inpatient visits across 700 hospitals in eight US states. We built a weighted, directed network connecting overlapping inpatient visits to measure facility-level CDI pressure. We then matched HCFO-CDIs with non-CDI controls on facility, comorbidities and demographics and performed a conditional logistic regression to determine the odds of developing HCFO-CDI given the number of coincident patient visits with CDI. On average, cases' visits coincided with 9.2 CDI cases, which for an individual with an average length of stay corresponded to an estimated 17.7% (95% CI 12.9–22.7%) increase in the odds of acquiring HCFO-CDI compared to an inpatient visit without concurrent CDI cases or fully isolated from both direct and indirect risks from concurrent CDI cases. These results suggest that, either directly or indirectly, hospital patients with CDI lead to CDIs in non-infected patients with temporally overlapping visits. Cambridge University Press 2022-12-11 /pmc/articles/PMC9990401/ /pubmed/36502810 http://dx.doi.org/10.1017/S0950268822001893 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited. |
spellingShingle | Original Paper Justice, Samuel Sewell, Daniel K. Li, Haomin Miller, Aaron C. Polgreen, Philip M. Evidence of within-facility patient–patient Clostridiodes difficile infection spread across diverse settings |
title | Evidence of within-facility patient–patient Clostridiodes difficile infection spread across diverse settings |
title_full | Evidence of within-facility patient–patient Clostridiodes difficile infection spread across diverse settings |
title_fullStr | Evidence of within-facility patient–patient Clostridiodes difficile infection spread across diverse settings |
title_full_unstemmed | Evidence of within-facility patient–patient Clostridiodes difficile infection spread across diverse settings |
title_short | Evidence of within-facility patient–patient Clostridiodes difficile infection spread across diverse settings |
title_sort | evidence of within-facility patient–patient clostridiodes difficile infection spread across diverse settings |
topic | Original Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9990401/ https://www.ncbi.nlm.nih.gov/pubmed/36502810 http://dx.doi.org/10.1017/S0950268822001893 |
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