Pharmacy, Health Sciences & Exercise Science
Comparative Outcomes of C. difficile Infected Patients with NAP1 vs. Non-NAP1 strains
Document Type
Oral Presentation
Location
Indianapolis, IN
Subject Area
Pharmacy, Health Sciences & Exercise Science
Start Date
11-4-2014 8:30 AM
End Date
11-4-2014 10:00 AM
Sponsor
Jarrett Amsden (Butler University)
Description
Background: Clostridium difficile is a spore-forming, anaerobic gram-positive bacillus that resides in both the environment and human gut flora. Carriage of C. difficile is often asymptomatic, but with changes to intrinsic host factors and/or exposure to extrinsic risk factors, most notably antibiotics and healthcare, C. difficile associated disease (CDAD) can manifest.CDAD is the most common cause of infectious diarrhea and is one of the leading causes of healthcare associated infections in the US.
Prior to 2000, CDAD attributable mortality was under 2%. Since 2000, North America and now Western Europe have seen dramatic increases in CDAD prevalence, incidence, morbidity and mortality. Parallel to these increases in CDAD was the emergence of a new more virulent strain of C. difficile that was identified as North American pulsed field type 1 (NAP1). This particular strain was not only determined to be resistant to fluoroquinolone antibiotics, but also demonstrated the ability to hyperproduce both toxins A and B. These changes in resistance and virulence are thought to be the most likely reasons for its rapid dissemination across North America and subsequent increases in CDAD severity, morbidity, mortality and higher rates of recurrence.
Study Objective: To compare all-cause mortality rates between patients with a NAP1 positive strain of C. difficile vs. patient's with non-NAP1 strains.
Materials and Methods: This study will be a retrospective comparative cohort study. Patients admitted from October 20, 2011 through August 31, 2012 with a positive C. difficile PCR will be included. Patients will be further grouped based upon their NAP1 status (positive or negative c) of their C. difficile strain.
Descriptive statistics will be utilized to characterize patient demographics. Demographic and clinical characteristics in the 2 groups will be compared using univariate Chi-Square tests or independent sample t-tests and analogous non-parametric tests will be utilized where appropriate. Multiple linear regression and logistic regression analysis will be used to examine the impact of NAP1 status on study outcomes after controlling for demographic and clinical differences.
Significance: The goal of this study is to improve our knowledge of C. difficile infections by analyzing outcomes of infected patients.
Comparative Outcomes of C. difficile Infected Patients with NAP1 vs. Non-NAP1 strains
Indianapolis, IN
Background: Clostridium difficile is a spore-forming, anaerobic gram-positive bacillus that resides in both the environment and human gut flora. Carriage of C. difficile is often asymptomatic, but with changes to intrinsic host factors and/or exposure to extrinsic risk factors, most notably antibiotics and healthcare, C. difficile associated disease (CDAD) can manifest.CDAD is the most common cause of infectious diarrhea and is one of the leading causes of healthcare associated infections in the US.
Prior to 2000, CDAD attributable mortality was under 2%. Since 2000, North America and now Western Europe have seen dramatic increases in CDAD prevalence, incidence, morbidity and mortality. Parallel to these increases in CDAD was the emergence of a new more virulent strain of C. difficile that was identified as North American pulsed field type 1 (NAP1). This particular strain was not only determined to be resistant to fluoroquinolone antibiotics, but also demonstrated the ability to hyperproduce both toxins A and B. These changes in resistance and virulence are thought to be the most likely reasons for its rapid dissemination across North America and subsequent increases in CDAD severity, morbidity, mortality and higher rates of recurrence.
Study Objective: To compare all-cause mortality rates between patients with a NAP1 positive strain of C. difficile vs. patient's with non-NAP1 strains.
Materials and Methods: This study will be a retrospective comparative cohort study. Patients admitted from October 20, 2011 through August 31, 2012 with a positive C. difficile PCR will be included. Patients will be further grouped based upon their NAP1 status (positive or negative c) of their C. difficile strain.
Descriptive statistics will be utilized to characterize patient demographics. Demographic and clinical characteristics in the 2 groups will be compared using univariate Chi-Square tests or independent sample t-tests and analogous non-parametric tests will be utilized where appropriate. Multiple linear regression and logistic regression analysis will be used to examine the impact of NAP1 status on study outcomes after controlling for demographic and clinical differences.
Significance: The goal of this study is to improve our knowledge of C. difficile infections by analyzing outcomes of infected patients.