ArticleBMC infectious diseases2011
Incidence of and risk factors for community-associated Clostridium difficile infection: a nested case-control study.
Article in BMC infectious diseases, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 70 papers, 8 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
70 citing papers in PubMed, 8 syntheses or guidelines pooled it.
- Epidemiologic profile of community-acquiredEpidemiology and infection · 2025Pooled it
- Recommendations for the diagnosis and treatment of Clostridioides difficile infection: An official clinical practice guideline of the Spanish Society of Chemotherapy (SEQ), Spanish Society of Internal Medicine (SEMI) and the working group of Postoperative Infection of the Spanish Society of Anesthesia and Reanimation (SEDAR).Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2020Guideline
- Global burden ofJournal of global health · 2019Pooled it
- Proton pump inhibitors therapy and risk of Clostridium difficile infection: Systematic review and meta-analysis.World journal of gastroenterology · 2017Pooled it
- Comparison of pediatric and adult antibiotic-associated diarrhea and Clostridium difficile infections.World journal of gastroenterology · 2016Pooled it
- Clostridium difficile infection seasonality: patterns across hemispheres and continents - a systematic review.PloS one · 2015Pooled it
- Meta-analysis of antibiotics and the risk of community-associated Clostridium difficile infection.Antimicrobial agents and chemotherapy · 2013Pooled it
- The association between histamine 2 receptor antagonist use and Clostridium difficile infection: a systematic review and meta-analysis.PloS one · 2013Pooled it
- One Health genomic insights into environmental and animal reservoirs of community-associatedApplied and environmental microbiology · 2026Article
- Epidemiology ofAntibiotics (Basel, Switzerland) · 2026Article
- Article
- Review
- Recurrent Clostridioides difficile Infection: Current Clinical Management and Microbiome-Based Therapies.BioDrugs : clinical immunotherapeutics, biopharmaceuticals and gene therapy · 2023Review
- Comparison of Different Antibiotics and the Risk for Community-AssociatedOpen forum infectious diseases · 2023Article
- Clostridioides difficile infection in infants: a case report and literature review.Gut pathogens · 2023Article
- The Environment, Farm Animals and Foods as Sources ofFoods (Basel, Switzerland) · 2023Article
- Clinical Use of Lansoprazole and the Risk of Osteoporosis: A Nationwide Cohort Study.International journal of environmental research and public health · 2022Article
- Review
- Proton-Pump Inhibitor Use and the Risk of Community-Associated Clostridium difficile Infection.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
- Antibiotic-Associated Adverse Events in Hospitalized Children.Journal of the Pediatric Infectious Diseases Society · 2021Observational
10 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
backgroundClostridium difficile is the most common cause of nosocomial infectious diarrhea in the United States. However, recent reports have documented that C. difficile infections (CDIs) are occurring among patients without traditional risk factors. The purpose of this study was to examine the epidemiology of CA-CDI, by estimating the incidence of CA-CDI and HA-CDI, identifying patient-related risk factors for CA-CDI, and describing adverse health outcomes of CA-CDI.
methodsWe conducted a population-based, retrospective, nested, case-control study within the University of Iowa Wellmark Data Repository from January 2004 to December 2007. We identified persons with CDI, determined whether infection was community-associated (CA) or hospital-acquired (HA), and calculated incidence rates. We collected demographic, clinical, and pharmacologic information for CA-CDI cases and controls (i.e., persons without CDI). We used conditional logistic regression to estimate the odds ratios (ORs) for potential risk factors for CA-CDI.
resultsThe incidence rates for CA-CDI and HA-CDI were 11.16 and 12.1 cases per 100,000 person-years, respectively. CA-CDI cases were more likely than controls to receive antimicrobials (adjusted OR, 6.09 [95% CI 4.59-8.08]) and gastric acid suppressants (adjusted OR, 2.30 [95% CI 1.56-3.39]) in the 180 days before diagnosis. Controlling for other covariates, increased risk for CA-CDI was associated with use of beta-lactam/beta-lactamase inhibitors, cephalosporins, clindamycin, fluoroquinolones, macrolides, and penicillins. However, 27% of CA-CDI cases did not receive antimicrobials in the 180 days before their diagnoses, and 17% did not have any traditional risk factors for CDI.
conclusionsOur study documented that the epidemiology of CDI is changing, with CA-CDI occurring in populations not traditionally considered "high-risk" for the disease. Clinicians should consider this diagnosis and obtain appropriate diagnostic testing for outpatients with persistent or severe diarrhea who have even remote antimicrobial exposure.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.