TY - JOUR
T1 - Correlation between hospital-level antibiotic consumption and incident health care facility-onset Clostridium difficile infection
AU - Crew, Page E.
AU - Rhodes, Nathaniel J.
AU - O'Donnell, J. Nicholas
AU - Miglis, Cristina
AU - Gilbert, Elise M.
AU - Zembower, Teresa R.
AU - Qi, Chao
AU - Silkaitis, Christina
AU - Sutton, Sarah H.
AU - Scheetz, Marc H.
N1 - Publisher Copyright:
© 2018
PY - 2018/3
Y1 - 2018/3
N2 - Background: The purpose of this single-center, ecologic study is to characterize the relationship between facility-wide (FacWide) antibiotic consumption and incident health care facility-onset Clostridium difficile infection (HO-CDI). Methods: FacWide antibiotic consumption and incident HO-CDI were tallied on a monthly basis and standardized, from January 2013 through April 2015. Spearman rank-order correlation coefficients were calculated using matched-months analysis and a 1-month delay. Regression analyses were performed, with P <.05 considered statistically significant. Results: FacWide analysis identified a matched-months correlation between ceftriaxone and HO-CDI (ρ = 0.44, P =.018). A unit of stem cell transplant recipients did not have significant correlation between carbapenems and HO-CDI in matched months (ρ = 0.37, P =.098), but a significant correlation was observed when a 1-month lag was applied (ρ = 0.54, P =.014). Discussion: Three statistically significant lag associations were observed between FacWide/unit-level antibiotic consumption and HO-CDI, and 1 statistically significant nonlagged association was observed FacWide. Antibiotic consumption may convey extended ward-level risk for incident CDI. Conclusions: Consumption of antibiotic agents may have immediate and prolonged influence on incident CDI. Additional studies are needed to investigate the immediate and delayed associations between antibiotic consumption and C difficile colonization, infection, and transmission at the hospital level.
AB - Background: The purpose of this single-center, ecologic study is to characterize the relationship between facility-wide (FacWide) antibiotic consumption and incident health care facility-onset Clostridium difficile infection (HO-CDI). Methods: FacWide antibiotic consumption and incident HO-CDI were tallied on a monthly basis and standardized, from January 2013 through April 2015. Spearman rank-order correlation coefficients were calculated using matched-months analysis and a 1-month delay. Regression analyses were performed, with P <.05 considered statistically significant. Results: FacWide analysis identified a matched-months correlation between ceftriaxone and HO-CDI (ρ = 0.44, P =.018). A unit of stem cell transplant recipients did not have significant correlation between carbapenems and HO-CDI in matched months (ρ = 0.37, P =.098), but a significant correlation was observed when a 1-month lag was applied (ρ = 0.54, P =.014). Discussion: Three statistically significant lag associations were observed between FacWide/unit-level antibiotic consumption and HO-CDI, and 1 statistically significant nonlagged association was observed FacWide. Antibiotic consumption may convey extended ward-level risk for incident CDI. Conclusions: Consumption of antibiotic agents may have immediate and prolonged influence on incident CDI. Additional studies are needed to investigate the immediate and delayed associations between antibiotic consumption and C difficile colonization, infection, and transmission at the hospital level.
KW - Antibiotic use
KW - Antimicrobial stewardship
KW - Healthcare-associated infections
KW - Statistical model
UR - http://www.scopus.com/inward/record.url?scp=85034989462&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85034989462&partnerID=8YFLogxK
U2 - 10.1016/j.ajic.2017.09.015
DO - 10.1016/j.ajic.2017.09.015
M3 - Article
C2 - 29169938
AN - SCOPUS:85034989462
VL - 46
SP - 270
EP - 275
JO - American Journal of Infection Control
JF - American Journal of Infection Control
SN - 0196-6553
IS - 3
ER -