SynthesisPloS one2015
Asymptomatic carriers of toxigenic C. difficile in long-term care facilities: a meta-analysis of prevalence and risk factors.
Synthesis in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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Who cites it
35 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Prevalence ofFrontiers in cellular and infection microbiology · 2022Pooled it
- Global burden and trends of theAnnals of medicine · 2025Observational
- Microbiome signatures ofmSphere · 2025Article
- Heterogeneity of Clostridioides difficile asymptomatic colonization prevalence: a systematic review and meta-analysis.Gut pathogens · 2025Article
- Efficacy and safety of faecal microbiota transplantation (FMT) in recurrentPrzeglad gastroenterologiczny · 2025Article
- Mortality Attributable toMedicina (Kaunas, Lithuania) · 2024Article
- [Analysis ofNan fang yi ke da xue xue bao = Journal of Southern Medical University · 2024Article
- The combined effect of systemic antibiotics and proton pump inhibitors on Clostridioides difficile infection and recurrence.The Journal of antimicrobial chemotherapy · 2024Article
- Analysis of risk factors for community-acquiredTranslational pediatrics · 2023Article
- Prevalence and risk factors of toxigenicFrontiers in medicine · 2023Article
- Article
- Risk Factors for Hospital Readmission forPathogens (Basel, Switzerland) · 2022Article
- Prevalence and Risk Factors for Multidrug-Resistant Organisms Colonization in Long-Term Care Facilities Around the World: A Review.Antibiotics (Basel, Switzerland) · 2021Review
- Epidemiology of community-acquired and recurrentTherapeutic advances in gastroenterology · 2021Review
- Trends in Hospitalizations for Clostridioides difficile Infection in End-Stage Liver Disease, 2005-2014.Digestive diseases and sciences · 2021Article
- Characterization of Non-ToxigenicJournal of clinical medicine · 2020Article
- Association Between Bisphosphonates and Hospitalized Clostridioides difficile Infection Among Frail Older Adults.Journal of the American Medical Directors Association · 2020Article
- Association of Community Factors with Hospital-onsetEClinicalMedicine · 2019Article
- Modeling Clostridium difficile in a hospital setting: control and admissions of colonized and symptomatic patients.Theoretical biology & medical modelling · 2019Article
- Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe impact of Clostridium difficile colonization in C. difficile infection (CDI) is inadequately explored. As a result, asymptomatic carriage is not considered in the development of infection control policies and the burden of carrier state in long-term care facilities (LTCFs) is unknown. PURPOSE: To explore the epidemiology of C. difficile colonization in LTCFs, identify predisposing factors and describe its impact on healthcare management. DATA SOURCES: PubMed, Embase and Web of Science (up to June 2014) without language restriction, complemented by reference lists of eligible studies. STUDY SELECTION: All studies providing extractable data on the prevalence of toxigenic C. difficile colonization among asymptomatic residents in LTCFs. DATA EXTRACTION: Two authors extracted data independently. STATISTICAL
methodsThe pooled colonization estimates were calculated using the double arcsine methodology and reported along with their 95% random-effects confidence intervals (CIs), using DerSimonian-Laird weights. We assessed the impact of patient-level covariates on the risk of colonization and effects were reported as odds ratios (OR, 95% CI). We used the colonization estimates to simulate the effective reproduction number R through a Monte Carlo technique.
resultsBased on data from 9 eligible studies that met the specified criteria and included 1,371 subjects, we found that 14.8% (95%CI 7.6%-24.0%) of LTCF residents are asymptomatic carriers of toxigenic C. difficile. Colonization estimates were significantly higher in facilities with prior CDI outbreak (30.1% vs. 6.5%, p = 0.01). Patient history of CDI (OR 6.07; 95% CI 2.06-17.88; effect derived from 3 studies), prior hospitalization (OR 2.11; 95% CI 1.08-4.13; derived from 3 studies) and antimicrobial use within previous 3 months (OR 3.68; 95% CI 2.04-6.62; derived from 4 studies) were associated with colonization. The predicted colonization rate at admission was 8.9%.
conclusionAsymptomatic carriage of toxigenic C. difficile represents a significant burden in LTCFs and is associated with prior CDI outbreaks in the facility, a history of CDI, prior hospitalization and antimicrobial use. These findings can impact infection control measures at LTCFs.
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