ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2018
Patient and Strain Characteristics Associated With Clostridium difficile Transmission and Adverse Outcomes.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 30 citations in OpenAlex.
- Genome sequencing for prevention of health-care-associated bacterial infections.Nature reviews. Microbiology · 2026Review
- Regression-based modeling of pairwise genomic linkage data identifies risk factors for healthcare-associated pathogen transmission: application to carbapenem-resistantMicrobiology spectrum · 2026Article
- Mortality Attributable toMedicina (Kaunas, Lithuania) · 2024Article
- Comparison of fidaxomicin, metronidazole and vancomycin for initial episode and recurrence ofHeliyon · 2024Article
- Comparative Genomics of Clostridioides difficile.Advances in experimental medicine and biology · 2024Article
- Trends in and Risk Factors for Recurrent Clostridioides difficile Infection, New Haven County, Connecticut, USA, 2015-2020.Emerging infectious diseases · 2023Review
- Molecular epidemiology of community- and hospital-associated Clostridioides difficile infections in Jönköping, Sweden, October 2017 - March 2018.APMIS : acta pathologica, microbiologica, et immunologica Scandinavica · 2022Article
- Infection prevention and control insights from a decade of pathogen whole-genome sequencing.The Journal of hospital infection · 2022Review
- Whole-genome sequencing surveillance and machine learning for healthcare outbreak detection and investigation: A systematic review and summary.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2022Review
- Neutrophil Ratio of White Blood Cells as a Prognostic Predictor ofJournal of inflammation research · 2022Article
- Human and Porcine Transmission of Clostridioides difficile Ribotype 078, Europe.Emerging infectious diseases · 2021Article
- A multisite genomic epidemiology study ofMicrobial genomics · 2021Article
- Genotypic correlation between post discharge Clostridiodes difficle infection (CDI) and previous unit-based contacts.The Journal of hospital infection · 2021Article
- Genetic Determinants of Trehalose Utilization Are Not Associated With SevereOpen forum infectious diseases · 2020Article
- Clostridioides (Formerly Clostridium) difficile Infection During Hospitalization Increases the Likelihood of Nonhome Patient Discharge.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2019Article
- Clostridium difficile trehalose metabolism variants are common and not associated with adverse patient outcomes when variably present in the same lineage.EBioMedicine · 2019Article
- Multilocus Variable-Number Tandem-Repeat Analysis of Clostridioides difficile Clusters in Ribotype 027 Isolates and Lack of Association with Clinical Outcomes.Journal of clinical microbiology · 2019Article
- The Challenges of Tracking Clostridium difficile to Its Source in Hospitalized Patients.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2019Article
- Two Distinct Patterns of Clostridium difficile Diversity Across Europe Indicating Contrasting Routes of Spread.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2018Article
Corrections and comments
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Authors and funding
10 authors at 5 institutions in 1 country.
Funding
Abstract
Background: No study has used whole-genome sequencing (WGS) to investigate risk factors for Clostridium difficile (CD) transmission between cases, or assessed the impact of recent acquisition on patient outcome. Methods: This 20 month retrospective cohort study included consecutive cytotoxin-positive diarrheal samples, which underwent culture, ribotyping, and WGS (Illumina). Sequenced isolates were compared using single nucleotide variants (SNVs). Independent predictors of acquisition from another case, onward transmission, 120-day recurrence, and 30-day mortality were identified using logistic regression with backwards elimination. Results: Of 660 CD cases, 640 (97%) were sequenced, of which 567 (89%) shared a ribotype with a prior case, but only 227 (35%) were ≤2 SNVs from a prior case, supporting recent acquisition. Plausible (<2 SNVs) recent ward-based acquisition from a symptomatic case was more frequent in certain ribotypes; 64% (67/105) for ribotype-027 cases, compared with 11% (6/57) for ribotype-078. Independent risk factors (adjusted P < .05) for CD acquisition included older age, longer inpatient duration, and ribotype; these factors, and male sex, increased onward transmission. Patients with a plausible donor had a greater risk of recurrence (adjusted P = .001) and trended towards greater 30-day mortality (adjusted P = .06). Ribotype had no additional mortality or recurrence impact after adjusting for acquisition (P > .1). Conclusions: Greater transmission of certain lineages suggests CD may have different reservoirs and modes of transmission. Acquiring CD from a recent case is associated with poorer clinical outcomes. Clinical characteristics associated with increased healthcare-associated CD transmission could be used to target preventative interventions.
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Registered trials
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.