Evidence map›Paper›PMID 28435086›Full record

Observational studyThe Journal of infection2017

Toxigenic Clostridium difficile colonization among hospitalised adults; risk factors and impact on survival.

Laura Behar, David Chadwick, Angela Dunne, Christopher I Jones, Claire Proctor, Chakravarthi Rajkumar, Paula Sharratt, Philip Stanley, Angela Whiley, Mark Wilks and 1 more

Open access · bronzeAbstract readObservational Study
In one paragraph

Observational study in The Journal of infection, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 pooled it
1.3field-weighted citation impact, top 22% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 2 syntheses or guidelines pooled it, 16 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Colonization of ToxigenicFrontiers in cellular and infection microbiology · 2020
    Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 5 institutions in 1 country.

Laura BeharBrighton and Sussex University Hospitals NHS Trust, Eastern Road, Brighton, East Sussex, BN2 5BE, United Kingdom.
David ChadwickThe James Cook University Hospital, Marton Road, Middlesbrough, TS4 3BW, United Kingdom.
Angela DunneBrighton and Sussex University Hospitals NHS Trust, Eastern Road, Brighton, East Sussex, BN2 5BE, United Kingdom.
Christopher I JonesBrighton and Sussex Medical School, University of Sussex, Falmer, East Sussex, BN1 9PS, United Kingdom.
Claire ProctorThe James Cook University Hospital, Marton Road, Middlesbrough, TS4 3BW, United Kingdom.
Chakravarthi RajkumarBrighton and Sussex University Hospitals NHS Trust, Eastern Road, Brighton, East Sussex, BN2 5BE, United Kingdom; Brighton and Sussex Medical School, University of Sussex, Falmer, East Sussex, BN1 9PS, United Kingdom.
Paula SharrattBradford Teaching Hospitals NHS Foundation Trust, Duckworth Lane, Bradford, BD9 6RJ, United Kingdom.
Philip StanleyBradford Teaching Hospitals NHS Foundation Trust, Duckworth Lane, Bradford, BD9 6RJ, United Kingdom.
Angela WhileyImmunobiology, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary, University of London, 4, Newark Street, London, E1 2AT, United Kingdom.
Mark WilksImmunobiology, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary, University of London, 4, Newark Street, London, E1 2AT, United Kingdom; Department of Infection, Barts Health NHS Trust, Pathology and Pharmacy, 80, Newark St, London, E1 2ES, United Kingdom.
Martin J LlewelynBrighton and Sussex University Hospitals NHS Trust, Eastern Road, Brighton, East Sussex, BN2 5BE, United Kingdom; Brighton and Sussex Medical School, University of Sussex, Falmer, East Sussex, BN1 9PS, United Kingdom. Electronic address: m.j.llewelyn@bsms.ac.uk.
Brighton and Sussex Medical School · GBBradford Teaching Hospitals NHS Foundation Trust · GBJames Cook University Hospital · GBQueen Mary University of London · GBUniversity Hospitals Sussex NHS Foundation Trust · GB

Funding

The Dunhill Medical Trust R215/0711
6 · The paper itself

Abstract

objectivesTo establish risk factors for Clostridium difficile colonization among hospitalized patients in England.

methodsPatients admitted to elderly medicine wards at three acute hospitals in England were recruited to a prospective observational study. Participants were asked to provide a stool sample as soon as possible after enrolment and then weekly during their hospital stay. Samples were cultured for C. difficile before ribotyping and toxin detection by PCR. A multivariable logistic regression model of risk factors for C. difficile colonization was fitted from univariable risk factors significant at the p < 0.05 level.

results410/727 participants submitted ≥1 stool sample and 40 (9.8%) carried toxigenic C. difficile in the first sample taken. Ribotype 106 was identified three times and seven other ribotypes twice. No ribotype 027 strains were identified. Independent predictors of colonization were previous C. difficile infection (OR 4.53 (95% C.I. 1.33-15.48) and malnutrition (MUST score ≥2) (OR 3.29 (95% C.I. 1.47-7.35)). Although C. difficile colonised patients experienced higher 90-day mortality, colonization was not an independent risk for death.

conclusionsIn a non-epidemic setting patients who have previously had CDI and have a MUST score of ≥2 are at increased risk of C. difficile colonization and could be targeted for active surveillance to prevent C. difficile transmission.

Indexed as

HospitalizationAged, 80 and overAnti-Bacterial AgentsBacterial ToxinsClostridioides difficileClostridium InfectionsCross InfectionDiarrheaEnglandEnterotoxinsFecesFemaleHumansLogistic ModelsMalePolymerase Chain ReactionAnti-Bacterial AgentsBacterial ToxinsEnterotoxinstcdA protein, Clostridium difficileClostridium difficileColonizationRisk factors

Identifiers

PMID28435086
PMCPMC5464213
OpenAlexW2606200971

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.