ArticlePloS one2014
ICU-Onset Clostridium difficile infection in a university hospital in China: a prospective cohort study.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 7 of them syntheses that pooled it.
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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.
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Who cites it
26 citing papers in PubMed, 7 syntheses or guidelines pooled it.
- Global burden ofJournal of global health · 2019Pooled it
- Implementation of infection prevention and control in acute care hospitals in Mainland China - a systematic review.Antimicrobial resistance and infection control · 2019Pooled it
- Magnitude and direction of the association between Clostridium difficile infection and proton pump inhibitors in adults and pediatric patients: a systematic review and meta-analysis.Journal of gastroenterology · 2018Pooled it
- Risk factors forJournal of global health · 2017Pooled it
- The emergence of Clostridium difficile infection in Asia: A systematic review and meta-analysis of incidence and impact.PloS one · 2017Pooled it
- Assessing the Risk of Hospital-Acquired Clostridium Difficile Infection With Proton Pump Inhibitor Use: A Meta-Analysis.Infection control and hospital epidemiology · 2016Pooled it
- The incidence and drug resistance of Clostridium difficile infection in Mainland China: a systematic review and meta-analysis.Scientific reports · 2016Pooled it
- Review
- Impact of targeted interventions on healthcare-acquired infection prevention and control of Clostridium difficile infections.Antimicrobial resistance and infection control · 2025Article
- Clinical characteristics and risk factors ofFrontiers in pediatrics · 2025Article
- Guidelines for Antibiotics Prescription in Critically Ill Patients.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2024Article
- Update on Commonly Used Molecular Typing Methods forMicroorganisms · 2023Review
- Clostridium difficile-associated Diarrhea in Developing Countries: A Systematic Review and Meta-Analysis.Infectious diseases and therapy · 2019Article
- Prevalence and antimicrobial susceptibility pattern of toxigenic Clostridium difficilestrains isolated in IranTurkish journal of medical sciences · 2019Article
- Guidelines for Antibiotic Prescription in Intensive Care Unit.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2019Article
- Review
- Incidence and Outbreak of Healthcare-Onset Healthcare-AssociatedFrontiers in microbiology · 2018Article
- Molecular epidemiology ofInfection and drug resistance · 2018Article
- Whole genome sequences of three Clade 3 Clostridium difficile strains carrying binary toxin genes in China.Scientific reports · 2017Article
- Frequency of antibiotic associated diarrhea caused byGastroenterology and hepatology from bed to bench · 2017Article
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
No grant is acknowledged in the PubMed record.
Abstract
A prospective study was conducted to investigate the incidence, clinical profiles and outcome of ICU-onset CDI in a 50-bed medical ICU at a university hospital in China. Stools were collected from patients who developed ICU-onset diarrhea and was screened for tcdA (toxin A gene) and tcdB (toxin B gene) by PCR. CDI cases were compared with the ICU-onset non-CDI diarrhea cases for demographics, comorbidities, potential risk factors, major laboratory findings and outcomes. Stool samples from CDI cases were subjected to C. difficile culture and C. difficile isolates were screened for tcdA, tcdB and the binary toxin genes (cdtA and cdtB) using multiplex PCR. Strain typing of toxigenic C. difficile isolates was performed using multilocus sequence typing. There were 1,277 patients in the ICU during the study period and 124 (9.7%) developed ICU-onset diarrhea, of which 31 patients had CDI. The incidence of ICU-onset CDI was 25.2 cases per 10,000 ICU days. ICU-onset CDI cases had similar features with ICU-onset non-CDI diarrhea cases including the use of proton pump inhibitors and antibacterial agents. The crude mortality rate of ICU-onset CDI was 22.6%, but the attributable mortality rate of ICU-onset CDI was only 3.2% here. Toxigenic C. difficile isolates were recovered from 28 out of the 31 patients with CDI. cdtA and cdtB were found in two strains. Seventeen STs including 11 new STs were identified. All of the 11 new STs were single-locus variants of known STs and the 17 STs identified here could be clustered into 3 clades. The incidence of ICU-onset CDI here is similar to those in Europe and North America, suggesting that CDI is likely to be a common problem in China. Toxigenic C. difficile here belonged to a variety of STs, which may represent a significant clonal expansion rather than the true clonal diversity.
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