Page E Crew1, Nathaniel J Rhodes1, J Nicholas O'Donnell1, Cristina Miglis1, Elise M Gilbert2, Teresa R Zembower3, Chao Qi4, Christina Silkaitis5, Sarah H Sutton3, Marc H Scheetz6. 1. Department of Pharmacy Practice, Chicago College of Pharmacy, Midwestern University, Downers Grove, IL; Department of Pharmacy, Northwestern Memorial Hospital, Chicago, IL. 2. Department of Pharmacy, Northwestern Memorial Hospital, Chicago, IL; Department of Pharmacy Practice, College of Pharmacy, Chicago State University, Chicago, IL. 3. Department of Internal Medicine, Division of Infectious Diseases, Feinberg School of Medicine, Northwestern University, Chicago, IL; Department of Healthcare Epidemiology and Infection Prevention, Northwestern Memorial Hospital, Chicago, IL. 4. Department of Pathology, Feinberg School of Medicine, Northwestern University, Chicago, IL. 5. Department of Healthcare Epidemiology and Infection Prevention, Northwestern Memorial Hospital, Chicago, IL. 6. Department of Pharmacy Practice, Chicago College of Pharmacy, Midwestern University, Downers Grove, IL; Department of Pharmacy, Northwestern Memorial Hospital, Chicago, IL. Electronic address: mschee@midwestern.edu.
Abstract
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. Published by Elsevier Inc.
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. Published by Elsevier Inc.
Entities:
Keywords:
Antibiotic use; Antimicrobial stewardship; Healthcare-associated infections; Statistical model
Authors: Amira A Bhalodi; Tjitske S R van Engelen; Harjeet S Virk; W Joost Wiersinga Journal: J Antimicrob Chemother Date: 2019-01-01 Impact factor: 5.790