ArticleEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2015
Predicting Clostridium difficile infection in diabetic patients and the effect of metformin therapy: a retrospective, case-control study.
Article in European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed, 31 citations in OpenAlex.
- Metabolic Syndrome Is Associated With Increased Risk ofOpen forum infectious diseases · 2026Article
- Antibiotic and Nonantibiotic Drugs Associated With Clostridioides difficile Infection Risk: a Pharmacopoeia-Wide Case-Cohort Study.The Journal of infectious diseases · 2026Article
- A critical role forActa pharmaceutica Sinica. B · 2025Article
- Diabetes Mellitus and the Risk and Outcomes ofInfection and drug resistance · 2025Review
- A Systematic Literature Review on Risk Factors for and Timing of Clostridioides difficile Infection in the United States.Infectious diseases and therapy · 2024Review
- Prevalence of Non-ToxigenicAntibiotics (Basel, Switzerland) · 2023Article
- Assessment of independent comorbidities and comorbidity measures in predicting healthcare facility-onset Clostridioides difficile infection in Kenya.PLOS global public health · 2022Article
- Clostridioides difficile Diarrhea: An Emerging Problem in a South Indian Tertiary Care Hospital.Journal of laboratory physicians · 2021Article
- Immunosuppression and Clostridioides (Clostridium) difficile Infection Risk in Metabolic and Bariatric Surgery Patients.Journal of the American College of Surgeons · 2021Article
- Nonalcoholic Fatty Liver Disease-A Novel Risk Factor for RecurrentAntibiotics (Basel, Switzerland) · 2021Article
- Influence ofFoods (Basel, Switzerland) · 2021Article
- Phenotypic and Genotypic Characteristics ofInfection and drug resistance · 2020Article
- Retrospective analysis of diabetic foot osteomyelitis management and outcome at a tertiary care hospital in the UK.PloS one · 2019Article
- A prospective cross sectional study of detection ofIranian journal of microbiology · 2018Article
- Diabetes Mellitus and the Colon.Current treatment options in gastroenterology · 2017Review
- Increasing incidence of Clostridium difficile infections: results from a 5-year retrospective study in a large teaching hospital in the Italian region with the oldest population.Epidemiology and infection · 2016Article
- Microbiota and pathogen 'pas de deux': setting up and breaking down barriers to intestinal infection.Pathogens and disease · 2016Review
- Older Is Not Wiser, Immunologically Speaking: Effect of Aging on Host Response to Clostridium difficile Infections.The journals of gerontology. Series A, Biological sciences and medical sciences · 2016Review
- Healthcare-associated Diarrhea due toEuroasian journal of hepato-gastroenterologyArticle
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Data on risk factors for Clostridium difficile infection (CDI) in diabetic patients are scarce. Recently, it has been shown that metformin increases the Bacteroidetes/Firmicutes ratio; therefore, it may yield a protective effect against CDI. We aimed to assess risk factors for CDI in diabetic patients beyond antibiotic treatment, and to determine the impact of metformin therapy on the development of CDI in these patients. In this retrospective, case-control study, all consecutive CDI diabetic patients, from January 2009 to December 2013, were included and compared to consecutive diabetic patients without CDI, hospitalized during the same period and in the same departments. Of 7,670 patients tested for C. difficile toxins, 486 were diabetics. Of them, 150 (30.8 %) were positive for C. difficile toxins and 336 (69.1 %) were negative. On multivariate analysis, metformin treatment was associated with a significant reduction in CDI [odds ratio (OR) = 0.58; 95 % confidence interval (CI), 0.37-0.93; p = 0.023], while heart failure was associated with significantly higher rates of CDI (OR = 1.654; 95 % CI, 1.007-2.716; p = 0.047), together with poor functional status, previous hospitalization, and abdominal surgery. Our findings suggest that, in diabetic patients, in addition to the well-recognized risk factors, heart failure is an additional risk factor for CDI, while metformin treatment seems to have a protective effect against the development of CDI. The exact mechanisms underlying this protective effect remain to be fully understood.
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