Article review ‘‘Hospital acquired Clostridium Difficile Infection (CDI) and risk factors for severity at a university hospital.’’

Article review ‘‘Hospital acquired Clostridium Difficile Infection (CDI) and risk factors for severity at a university hospital.’’

The article selected for this discussion is titled, ‘‘Hospital acquired Clostridium Difficile Infection (CDI) and risk factors for severity at a university hospital.’’ The authors of this article are Hüseyin Bilgin MD, Elvan Sayın MD, Hande Perk Gürün MD, Elif Tükenmez-Tigen MD, Nurver Ülger Toprak MD and Volkan Korten MD. This article was published in the American Journal of Infection Control in 2020 (Bilgin et al, 2020). The aim of the study was to investigate the incidence, clinical characteristics and factors associated with CDI in a tertiary care university hospital in Istanbul, Turkey (Bilgin et al, 2020).

A cohort study was conducted between January 2012 and December 2016 at Marmara University Hospital. Cohort studies are a type of longitudinal study which uses an approach that follows research participants over a period (Barrett, 2019). Specifically, cohort studies recruit and follow participants who share a common characteristic, such as a particular occupation. During the period of follow-up, some of the cohort will be exposed to a specific risk factor or characteristic; by measuring outcomes over a period, it is then possible to explore the impact of this variable (e. g, identifying the link between hospitalization and CDI.) They  help researchers build an understanding of what factors increase or decrease the likelihood of developing disease. Cohort studies are an effective method of establishing cause and effect (Barrett, 2019).

The researchers recruited adult patients (≥18 years old) who had positive stool assays for C. difficile toxin A or B or toxigenic culture to the study. Potential predictors for severe CDI are age, sex, co-morbidities, previous hospitalization, surgical procedures, antimicrobial use, proton pump inhibitor use, cancer chemotherapy, and parenteral nutrition. Researchers collected information concerning the severity of the disea=se, treatment regimen, treatment response, disease recurrence, and 30-day mortality rate (Bilgin et al, 2020).

A total of 111 patients developed CDI during the study period. Eleven patients (9.9%) were diagnosed with community-acquired CDI and excluded from the study. The remaining 100 patients were diagnosed with HA-CDI, resulting in a 2012-2016 incidence rate of 1.19 per 10,000 patient-days (Bilgin et al, 2020).

This study had several limitations. First, it was a single-center study representing a small part of the patient population in Istanbul, Turkey (Bilgin et al, 2020). The researchers did not perform an active screening for CDI. Only patients with clinical indications were tested. Therefore, the results could be an underestimation of the true incidence of HA-CDI. Another limitation could be the small sample size of the study. Larger sample size could predict whether there are any other specific risk factors for severe CDI (Bilgin et al, 2020).

Title of the Article: Hospital acquired Clostridium difficile infection and risk factors for severity in a university hospital: A prospective study.

Permalink: Hospital acquired Clostridioides difficile infection and risk factors for s…: GCU Library Resources – All Subjects (oclc.org)

References

Barrett. (2019). What are cohort studies? Retrieved from https://ebn.bmj.com/content/22/4

Bilgin et al. (2020). Hospital acquired Clostridium difficile infection and risk factors. Retrieved from https://eds-p-ebscohost-com.lopes.idm.oclc.org/eds/detail/detail?vid=2&sid=b3948e61-bc0b-4855-931d-c2bc6ff9635