SynthesisThe American journal of gastroenterology2015
Colonization with toxinogenic C. difficile upon hospital admission, and risk of infection: a systematic review and meta-analysis.
Synthesis in The American journal of gastroenterology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 113 papers, 6 of them syntheses that pooled it.
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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.
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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
113 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- The value of fecal calprotectin inFrontiers in physiology · 2022Pooled it
- Clinical Practice Guidelines for Clostridium difficile Infection in Adults and Children: 2017 Update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA).Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2018Guideline
- Guideline
- Prevalence of ESBL-Producing Enterobacteriaceae in Pediatric Bloodstream Infections: A Systematic Review and Meta-Analysis.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
- Systematic Review and Meta-analysis of Clinical and Economic Outcomes from the Implementation of Hospital-Based Antimicrobial Stewardship Programs.Antimicrobial agents and chemotherapy · 2016Pooled it
- Trial
- Article
- Relationship BetweenOpen forum infectious diseases · 2026Article
- Clostridioides difficile colonization amplification despite limited in-hospital transmission: A modeling study.PLoS medicine · 2026Article
- Genome sequencing for prevention of health-care-associated bacterial infections.Nature reviews. Microbiology · 2026Review
- Article
- Pooled analyses of Clostridioides difficile vaccine trials identify baseline predictors for vaccine response.Scientific reports · 2026Article
- Risk factors for progression fromInfection control and hospital epidemiology · 2026Article
- Observational
- Clostridioides difficile Infection in Healthy Children After Antibiotic Use: A Report of Two Cases.Cureus · 2025Article
- Natural History of Clostridioides difficile-Related Disease Progression in the 2-Step Testing Era.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Article
- Global Patterns ofCrohn's & colitis 360 · 2025Article
- Environmental and Health Care Personnel Sampling and Unobserved Clostridium difficile Transmission in ICU.JAMA network open · 2025Observational
- Impact of Clostridium difficile Infection Versus Colonization on Postoperative Outcomes After Oncological Colorectal Surgery: An Observational Single-Center Study With Propensity Score Analysis.Journal of surgical oncology · 2025Observational
53 more citing papers are in PubMed but not listed here.
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5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesIt has been suggested that colonization with C. difficile protects from infection. Nevertheless, the association between carriage of toxinogenic strains and ensuing C. difficile infections (CDIs) has not been studied.
methodsWe searched PubMed and EMBASE databases up to 20 June 2014, using the term "difficile". Our primary outcomes of interest included the prevalence of isolation of toxinogenic C. difficile or its toxins from asymptomatic patients on hospital admission through stool or rectal swab testing and the risk of ensuing infection among colonized and noncolonized patients. Data on previous hospitalization, antibiotic, and proton pump inhibitor (PPI) use and prior CDIs among colonized and noncolonized patients were also extracted.
resultsNineteen out of 26,081 studies on 8,725 patients were included. The pooled prevalence of toxinogenic C. difficile colonization was 8.1% (95% confidence interval (CI) 5.7-11.1%), with an increasing trend over time (P=0.003), and 10.0% (95% CI 7.1-13.4%) among North American studies. Patients colonized upon hospital admission had a 5.9 times higher risk of subsequent CDIs compared with noncolonized patients (relative risk (RR) 5.86; 95% CI 4.21-8.16). The risk of CDI for colonized patients was 21.8% (95% CI 7.9-40.1%), which was significantly higher than that of noncolonized patients (3.4%; 95% CI 1.5-6.0%; P=0.03), with an attributable risk of 18.4%. History of hospitalization during the previous 3 months was associated with a higher risk of colonization (RR 1.63; 95% CI 1.13-2.34), as opposed to previous antibiotic (RR 1.07; 95% CI 0.75-1.53) and PPI use (RR 1.44; 95% CI 0.94-2.23), as well as history of CDI (RR 1.45; 95% CI 0.66-3.18) that had no impact.
conclusionsOver 8% of admitted patients are carriers of toxinogenic C. difficile with an almost 6 times higher risk of infection. These findings update current knowledge regarding the contribution of colonization in CDI epidemiology and stress the importance of preventive measures toward colonized patients.
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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.