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

Publication date: March 2018
Source:American Journal of Infection Control, Volume 46, Issue 3
Author(s): Page E. Crew, Nathaniel J. Rhodes, J. Nicholas O'Donnell, Cristina Miglis, Elise M. Gilbert, Teresa R. Zembower, Chao Qi, Christina Silkaitis, Sarah H. Sutton, Marc H. Scheetz
BackgroundThe 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).MethodsFacWide 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.ResultsFacWide 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).DiscussionThree 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.ConclusionsConsumption 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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