Evidence map›Paper›PMID 30869054›Full record

ArticleEpidemiology and infection2019

Comparing the epidemiology of community- and hospital-associated Clostridium difficile infections in Northern Ireland, 2012-2016: a population data linkage and case-case study.

A Maisa, G Ross, N Q Verlander, D Fairley, D T Bradley, L Patterson

Abstract readComparative Study
In one paragraph

Article in Epidemiology and infection, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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, 1 synthesis or guideline pooled it.

  1. Epidemiologic profile of community-acquiredEpidemiology and infection · 2025
    Pooled it
  2. Article
  3. The Global Burden ofInfectious disease reports · 2025
    Review
  4. Article
  5. Risk Factors Associated with RecurrentHealthcare (Basel, Switzerland) · 2020
    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

6 authors.

A MaisaPublic Health Agency, Health Protection Service Northern Ireland,Belfast,Northern Ireland.ORCID 0000-0002-8372-7525
G RossPublic Health Agency, Health Protection Service Northern Ireland,Belfast,Northern Ireland.
N Q VerlanderStatistics Unit, Statistics, Modelling and Economics Department,Public Health England,Colindale,England.
D FairleyDepartment of Microbiology,Belfast Health and Social Care Trust,Belfast,Northern Ireland.
D T BradleyPublic Health Agency, Health Protection Service Northern Ireland,Belfast,Northern Ireland.
L PattersonPublic Health Agency, Health Protection Service Northern Ireland,Belfast,Northern Ireland.ORCID 0000-0002-4186-2884

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The burden of community-associated Clostridium difficile infection (CA-CDI) has increased. We aimed to describe the epidemiology of CA-CDI to inform future interventions. We used population-based linked surveillance data from 2012 to 2016 to describe socio-demographic factors, ribotype and mortality for all CA (n = 1303) and hospital-associated (HA, n = 1356) CDI. For 483 community-onset (CO) CA-CDI and 287 COHA-CDI cases, a questionnaire on risk factors was completed and we conducted a case-case study using logistic regression models for univariate and multivariable analysis. CA-CDI cases had lower odds of being male (adjusted odds ratio (AOR) 0.71, 95% confidence interval (CI) 0.58-0.87; P < 0.001), and higher odds of living in rural rather than urban settlement (AOR 1.5, 95% CI 1.1-2.1; P = 0.05) compared with HA-CDI cases. The distribution of ribotypes was similar in both groups with RT078 being most prevalent. CDI-specific death was lower in CA-CDI than HA-CDI (7% vs. 11%, P < 0.001). COCA-CDI had lower odds of having had an outpatient appointment in the previous 4 weeks compared with COHA-CDI (AOR 0.61; 95% CI 0.41-0.9, P = 0.01) and lower odds of being in a care home or hospice when compared with their own home, than COHA-CDI (AOR 0.66; 95% CI 0.45-0.98 and AOR 0.35; 95% CI 0.13-0.92, P = 0.02). Exposure to gastric acid suppressants (50% in COCA-CDI and 55% in COHA-CDI) and antimicrobial therapy (18% in COCA-CDI and 20% in COHA-CDI) prior to CDI was similar. Our analysis of community-onset cases suggests that other risk factors for COHA-CDI may be equally important for COCA-CDI. Opportunities to safely reduce antibiotic and gastric acid suppressants use should be investigated in all healthcare settings.

Indexed as

AdolescentAdultAgedAged, 80 and overChildChild, PreschoolClostridium InfectionsCommunity-Acquired InfectionsCross InfectionFemaleHumansIncidenceMaleMiddle AgedNorthern IrelandRisk FactorsClostridium difficilecommunity-associated infectionshospital-associatedribotyperisk factors

Identifiers

PMID30869054
PMCPMC6518519

What OpenQuestion holds

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LicenceCC BY
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.