ArticleBMC infectious diseases2026
Effect of the ribotype 027 strain on Clostridioides difficile infection outcomes and recurrence in the Veterans Affairs healthcare system: a propensity scores matching study.
Article in BMC infectious diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundClostridioides difficile infection (CDI) caused by epidemic ribotype 027 strains has been associated with increased morbidity and mortality. However, many studies evaluating outcomes have been limited due to small sample size and inclusion of only one facility.
methodsUsing a nationwide cohort of hospitalized patients in the Veterans Health System, we conducted a retrospective cohort study to examine the impact of infection with the 027 strain on severity of illness and recurrence in adults treated for CDI between October 2009 and September 2020. Cases of infection due to ribotype 027 were compared to control infections due to non-027 strains after balancing on patient characteristics using propensity score matching. Outcomes included recurrence of CDI, severe illness, and mortality at 14, 30, and 90 days after diagnosis.
resultsIn the unadjusted analysis, infection with ribotype 027 was associated with increased odds of recurrence and intensive care unit admission, severe CDI, colectomy, and death. For propensity score matching, 3709 cases of CDI due to ribotype 027 were successfully matched to 11,127 controls. After matching, infection with the ribotype 027 strain was only linked to increased risk of CDI recurrence (14.9% versus 10.5%, OR = 1.7, 95% CI, 1.55-1.86).
conclusionAfter propensity score matching, we found that infection with the ribotype 027 strain was associated with recurrence of CDI, but not with increased severity of illness or mortality.
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