The Attributable Burden of Clostridium difficile Infection to Long-Term Care Facilities Stay: A Clinical Study

Styliani Karanika, Christos Grigoras, Myrto E. Flokas, Michail Alevizakos, Tori Kinamon, Erna M. Kojic, Eleftherios Mylonakis

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

Background: Advanced age, history of hospitalization, and antibiotic consumption are associated with the pathogenesis of Clostridium difficile infection (CDI). Long-term care facilities (LTCFs) represent a setting where CDI has been increasingly reported. We aimed to estimate the actual attributable burden of CDI to LTCF stay and determine the characteristics of the disease epidemiology in this setting. Design: IRB-approved retrospective cohort study. Setting: LTCF and community. Participants: One thousand seven hundred and sixty-one patients. Measurements/Results: The prevalence of CDI among LTCF residents was 22.4%, whereas the prevalence of CDI among community residents was 6.7% (P <.001). The prevalence of CDI among LTCF residents was significantly higher in both the 18–64 (P <.001) and the ≥65 age groups (P <.010). Measures of hospital exposure and antibiotic consumption between LTCF and community residents prior to CDI diagnosis were non-significant. A strict matching (1:2) between LTCF and community residents adjusting for age, total number of hospital admissions and antibiotic consumption showed that the odds of CDI for an LTCF resident were 6.89 times larger than the odds for a community resident (OR = 6.89, 95%, 4.67–10.17). For an LTCF resident with CDI, the odds of manifesting severe disease were 3.25 times larger than the odds for a community resident with CDI (OR = 3.25, 95%, 1.81–5.86). LTCF residents were more frequently hospitalized (P =.002) required longer hospital stays for their CDI management (P =.03) and had more recurrent CDI cases than community residents (P =.04). Conclusions: Our study highlights the increased burden of CDI among LTCF residents independently of age, antibiotic, and hospitalization background. Severe CDI disease and recurrences are more frequent in LTCFs.

Original languageEnglish
Pages (from-to)1733-1740
Number of pages8
JournalJournal of the American Geriatrics Society
Volume65
Issue number8
DOIs
StatePublished - Aug 2017
Externally publishedYes

Keywords

  • Clostridium difficile Infection
  • long-term care facilities
  • matched cohort study
  • prevalence
  • severity

Fingerprint

Dive into the research topics of 'The Attributable Burden of Clostridium difficile Infection to Long-Term Care Facilities Stay: A Clinical Study'. Together they form a unique fingerprint.

Cite this