Identification of novel risk factors for community-acquired Clostridium difficile infection using spatial statistics and geographic information system analyses

PloS One
Deverick J AndersonCDC Prevention Epicenters Program

Abstract

The rate of community-acquired Clostridium difficile infection (CA-CDI) is increasing. While receipt of antibiotics remains an important risk factor for CDI, studies related to acquisition of C. difficile outside of hospitals are lacking. As a result, risk factors for exposure to C. difficile in community settings have been inadequately studied. To identify novel environmental risk factors for CA-CDI. We performed a population-based retrospective cohort study of patients with CA-CDI from 1/1/2007 through 12/31/2014 in a 10-county area in central North Carolina. 360 Census Tracts in these 10 counties were used as the demographic Geographic Information System (GIS) base-map. Longitude and latitude (X, Y) coordinates were generated from patient home addresses and overlaid to Census Tracts polygons using ArcGIS; ArcView was used to assess "hot-spots" or clusters of CA-CDI. We then constructed a mixed hierarchical model to identify environmental variables independently associated with increased rates of CA-CDI. A total of 1,895 unique patients met our criteria for CA-CDI. The mean patient age was 54.5 years; 62% were female and 70% were Caucasian. 402 (21%) patient addresses were located in "hot spots" or clusters of CA-CDI (p<0.001...Continue Reading

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Citations

Mar 20, 2018·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Sara L Revolinski, L Silvia Munoz-Price
Jan 12, 2019·Annual Review of Public Health·Peng JiaYoufa Wang
Aug 29, 2018·Gastroenterology Report·Alexander W W Brown, Robert B Wilson
Jan 2, 2019·Tropical Medicine and Infectious Disease·Deirdre A Collins, Thomas V Riley
Dec 20, 2019·PLoS Pathogens·Nicholas A TurnerSarah S Lewis
Jun 20, 2020·International Journal of Colorectal Disease·Daryl RamaiJames Gasperino
Aug 24, 2021·Emerging Infectious Diseases·Geraldine MoloneyThomas R Rogers

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Methods Mentioned

BETA
PCR

Software Mentioned

Ord
TomTom
ArcGIS
Getis Ord
SICCODES
SAS
SAS Data Management Studio
Getis

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