Risk factors for Clostridium difficile infection in the community: a case-control study in patients in general practice, Denmark, 2009-2011

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Risk factors for Clostridium difficile infection in the community: a case-control study in patients in general practice, Denmark, 2009-2011. / Soes, L. M.; Holt, H. M.; Böttiger, Blenda; Nielsen, H. V.; Andreasen, V.; Kemp, M.; Olsen, K. E. P.; Ethelberg, S.; Molbak, K.

In: Epidemiology and Infection, Vol. 142, No. 7, 2014, p. 1437-1448.

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Soes, L. M. ; Holt, H. M. ; Böttiger, Blenda ; Nielsen, H. V. ; Andreasen, V. ; Kemp, M. ; Olsen, K. E. P. ; Ethelberg, S. ; Molbak, K. / Risk factors for Clostridium difficile infection in the community: a case-control study in patients in general practice, Denmark, 2009-2011. In: Epidemiology and Infection. 2014 ; Vol. 142, No. 7. pp. 1437-1448.

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TY - JOUR

T1 - Risk factors for Clostridium difficile infection in the community: a case-control study in patients in general practice, Denmark, 2009-2011

AU - Soes, L. M.

AU - Holt, H. M.

AU - Böttiger, Blenda

AU - Nielsen, H. V.

AU - Andreasen, V.

AU - Kemp, M.

AU - Olsen, K. E. P.

AU - Ethelberg, S.

AU - Molbak, K.

PY - 2014

Y1 - 2014

N2 - To identify risk factors for Clostridium difficile infection (CDI) in Danish patients consulting general practice with gastrointestinal symptoms, a prospective matched case-control study was performed; cases (N=259) had positive cultures for toxigenic C. difficile and controls (N=455) negative cultures. Data were analysed by conditional logistic regression. In patients aged 2 years (138 cases), hospitalization [odds ratio (OR) 84, 95% confidence interval (CI) 31-23], consumption of beef (OR 55, 95% CI 20-15), phenoxymethylpenicillin (OR 15, 95% CI 27-82), dicloxacillin (OR 27, 95% CI 36-211), and extended spectrum penicillins (OR 92, 95% CI 19-45) were associated with CDI. In patients aged <2 years none of these were associated with CDI, but in a subgroup analysis contact with animals was associated with CDI (OR 81, 95% CI 10-64). This study emphasizes narrow-spectrum penicillins, and suggests beef consumption, as risk factors for CDI in adults, and indicates a different epidemiology of CDI in infants.

AB - To identify risk factors for Clostridium difficile infection (CDI) in Danish patients consulting general practice with gastrointestinal symptoms, a prospective matched case-control study was performed; cases (N=259) had positive cultures for toxigenic C. difficile and controls (N=455) negative cultures. Data were analysed by conditional logistic regression. In patients aged 2 years (138 cases), hospitalization [odds ratio (OR) 84, 95% confidence interval (CI) 31-23], consumption of beef (OR 55, 95% CI 20-15), phenoxymethylpenicillin (OR 15, 95% CI 27-82), dicloxacillin (OR 27, 95% CI 36-211), and extended spectrum penicillins (OR 92, 95% CI 19-45) were associated with CDI. In patients aged <2 years none of these were associated with CDI, but in a subgroup analysis contact with animals was associated with CDI (OR 81, 95% CI 10-64). This study emphasizes narrow-spectrum penicillins, and suggests beef consumption, as risk factors for CDI in adults, and indicates a different epidemiology of CDI in infants.

KW - Antibiotics

KW - case-control study

KW - children

KW - community-associated

KW - Clostridium difficile infection

KW - zoonoses

U2 - 10.1017/S0950268813002380

DO - 10.1017/S0950268813002380

M3 - Article

VL - 142

SP - 1437

EP - 1448

JO - Epidemiology and Infection

JF - Epidemiology and Infection

SN - 0950-2688

IS - 7

ER -