Universität zu Köln

Kipnis, Marina, Schwab, Frank, Kramer, Tobias S., Stegemann, Miriam S., Isner, Caroline, Pilarski, Georg, Maertin, Nayana, Boldt, Anne-C., Behnke, Michael, Denkel, Luisa A., Wiese-Posselt, Miriam, Zweigner, Janine, Gastmeier, Petra ORCID: 0000-0001-5520-4287 and Rohde, Anna M. (2019). Incidence of healthcare-associated Clostridioides difficile infections and association with ward-level antibiotic consumption in a German university hospital: an ecological study. J. Antimicrob. Chemother., 74 (8). S. 2400 - 2405. OXFORD: OXFORD UNIV PRESS. ISSN 1460-2091

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Abstract

Objectives: Clostridioides difficile infection (CDI) is one of the most important healthcare-associated infections. We aimed to describe the incidence density of healthcare-associated CDI (HA-CDI) in Germany's largest hospital and to identify associations with ward-level antimicrobial consumption. Methods: We used surveillance data on CDI and antimicrobial consumption from 2014 to 2017 and analysed a potential association by means of multivariable regression analysis. Results: We included 77 wards with 404998 admitted patients and 1850862 patient-days. Six hundred and seventy-one HA-CDI cases were identified, resulting in a pooled mean incidence density of 0.36/1000 patient-days (IQR = 0.34-0.39). HA-CDI incidence density on ICU and haematological-oncological wards was about three times higher than on surgical wards [incidence rate ratio (IRR)= 3.00 (95% CI = 1.96-4.60) and IRR = 2.78 (95% CI = 1.88-4.11), respectively]. Ward-level consumption of third-generation cephalosporins was the sole antimicrobial risk factor for HA-CDI. With each DDD/100 patient-days administered, a ward's HA-CDI incidence density increased by 2% [IRR = 1.02 (95% CI = 1.01-1.04)]. Other risk factors were contemporaneous community-associated CDI cases [IRR = 1.32 (95% CI = 1.07-1.63)] and CDI cases in the previous month [IRR = 1.27 (95% CI = 1.07-1.51)]. Furthermore, we found a significant decrease in HA-CDI in 2017 compared with 2014 [IRR = 0.68 (95% CI = 0.54-0.86)]. Conclusions: We confirmed that ward-level antimicrobial use influences HA-CDI and specifically identified third-generation cephalosporin consumption as a risk factor.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Kipnis, Marina UNSPECIFIED UNSPECIFIED UNSPECIFIED Schwab, Frank UNSPECIFIED UNSPECIFIED UNSPECIFIED Kramer, Tobias S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Stegemann, Miriam S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Isner, Caroline UNSPECIFIED UNSPECIFIED UNSPECIFIED Pilarski, Georg UNSPECIFIED UNSPECIFIED UNSPECIFIED Maertin, Nayana UNSPECIFIED UNSPECIFIED UNSPECIFIED Boldt, Anne-C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Behnke, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Denkel, Luisa A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wiese-Posselt, Miriam UNSPECIFIED UNSPECIFIED UNSPECIFIED Zweigner, Janine UNSPECIFIED UNSPECIFIED UNSPECIFIED Gastmeier, Petra UNSPECIFIED orcid.org/0000-0001-5520-4287 UNSPECIFIED Rohde, Anna M. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-145273
DOI:	10.1093/jac/dkz195
Journal or Publication Title:	J. Antimicrob. Chemother.
Volume:	74
Number:	8
Page Range:	S. 2400 - 2405
Date:	2019
Publisher:	OXFORD UNIV PRESS
Place of Publication:	OXFORD
ISSN:	1460-2091
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language FLUOROQUINOLONE USE; RISK-FACTORS; DISEASE; TIME Multiple languages Infectious Diseases; Microbiology; Pharmacology & Pharmacy Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/14527