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Correlation between hospital-level antibiotic consumption and incident health care facility-onset Clostridium difficile infection.

Correlation between hospital-level antibiotic consumption and incident health care facility-onset Clostridium difficile infection.
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Crew PE, Rhodes NJ, O'Donnell JN, Miglis C, Gilbert EM, Zembower TR, Qi C, Silkaitis C, Sutton SH, Scheetz MH,


Crew PE, Rhodes NJ, O'Donnell JN, Miglis C, Gilbert EM, Zembower TR, Qi C, Silkaitis C, Sutton SH, Scheetz MH, (click to view)

Crew PE, Rhodes NJ, O'Donnell JN, Miglis C, Gilbert EM, Zembower TR, Qi C, Silkaitis C, Sutton SH, Scheetz MH,

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American journal of infection control 2017 11 21() pii S0196-6553(17)31067-2
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.

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