| 1. |
- Soes, L. M., et al.
(författare)
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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
- 2014
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Ingår i: Epidemiology and Infection. - 0950-2688. ; 142:7, s. 1437-1448
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Tidskriftsartikel (refereegranskat)abstract
- 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.
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| 2. |
- Soes, L. M., et al.
(författare)
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The incidence and clinical symptomatology of Clostridium difficile infections in a community setting in a cohort of Danish patients attending general practice
- 2014
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Ingår i: European Journal of Clinical Microbiology & Infectious Diseases. - : Springer Science and Business Media LLC. - 1435-4373 .- 0934-9723. ; 33:6, s. 957-967
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Tidskriftsartikel (refereegranskat)abstract
- Clostridium difficile infection (CDI) is gradually being recognised as a cause of morbidity in the community. We investigated the incidence and clinical characteristics of CDI in a community setting and characterised the C. difficile strains by toxin gene profiling and polymerase chain reaction (PCR) ribotyping. Patients included in the study had attended general practice, primarily because of diarrhoea; CDI patients (259 patients; 121 < 2 years of age) had positive cultures for toxigenic C. difficile and non-CDI patients (455 patients) were culture-negative. Outcome variables included the frequency and duration of diarrhoea, vomiting, stomach ache, fever > 38 A degrees C, weight loss and sick leave. Data were analysed by logistic regression. CDI patients < 2 and a parts per thousand yen2 years of age with C. difficile as the only enteropathogen in the faecal sample reported slimy stools (65 % vs. 62 %), stomach ache (60 % vs. 75 %), weight loss (50 % vs. 76 %) and duration of diarrhoea > 15 days (59 % vs. 73 %) as the predominant symptoms. CDI patients a parts per thousand yen2 years old reported duration of diarrhoea > 15 days more often compared to non-CDI patients (73 % vs. 27 %, p < 0.0001). The annual incidence of CDI was 518 and 23/100,000 for patients < 2 and a parts per thousand yen2 years of age, respectively, and 46/100,000 in the subgroup of patients a parts per thousand yen60 years of age. CDI was characterised by stomach ache and persistent diarrhoea, often leading to weight loss. This emphasises the importance of diagnosing CDI not only in hospitalised patients, but also in individuals a parts per thousand yen2 years of age attending general practice because of gastrointestinal symptoms, especially in the elderly, where the incidence of CDI is high.
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