2104. Observational Study of Risk factors for Clostridium difficile Infection in Hospitalised Patients with Infective Diarrhoea (ORCHID): Consistency of Risk Factors
Session: Poster Abstract Session: Clostridium difficile: Risk Factors
Saturday, October 29, 2016
Room: Poster Hall
Posters
  • Poster for ID week 2016.pdf (459.1 kB)
  • Background:

    To use 2 C. difficile infection (CDI) case-control studies to determine consistency of risk factors (RF) in hospitalised patients with diarrhoea.

    Methods:

    Cohorts of CDI cases/controls were identified by standardised testing from 7 countries with high CDI rates in the prior EUCLID study. Parallel cohorts of CDI cases/controls were identified at UHC, Germany (parallel study site (PSS)). Data were extracted from the medical notes via a questionnaire to assess CDI RF. Univariate analyses (UV) and multivariate logistic regression model (MV) were used to evaluate consistency of RF between two studies.

    Results:

    There were 253 and 158 cases and 921 and 584 controls in the PSS and EUCLID cohorts, respectively. Significant (SIG) variables from UV in both cohorts were age >65, number of antibiotics and prior hospital admission (PHA) (all p<0.001). Congestive heart failure (CHF), diabetes, admitted (ADM) from assisted living or Emergency Dept, proton pump inhibitors (PPIs) and chronic renal disease were SIG in PSS (all p<0.05) but not EUCLID. Dementia and ADM with other bacterial diseases (ABD) were SIG in EUCLID (p<0.005) but not PSS.

    MV consistently identified age >65, number of antibiotics and PHA as SIG in each independent model and combined datasets. Patients ABD remained SIG in the EUCLID model, while CHF, ADM with intestinal infection and PPIs remained SIG in the PSS model. All other variables were non-SIG.

    Conclusion:

    Results indicated that only some CDI RF are constant across datasets. SIG RF for CDI consistent across all models were age >65 years, antibiotic use and PHA. The odds of developing CDI increases with each extra antibiotic prescribed.

    This study was sponsored by University of Leeds; funding was provided by Pfizer Inc.

     


     

     

    EUCLID

    PSS

    Combined

    Univariate (UV)

    Multivariate (MV)

    UV

    MV

    UV

    MV

     

    Odds ratio (OR) (95% CI)

    OR (95% CI)

    OR (95% CI)

    OR (95% CI)

    OR (95% CI)

    OR (95% CI)

    Age >65

    2.4 (1.6-3.5)*

    2.5 (1.6-3.7)*

    1.8 (1.4-2.5)*

    1.6 (1.2-2.3)^

    2.0 (1.6-2.6)*

    1.9 (1.5-2.5)*

    Number of antibiotics

    1.3 (1.1-1.5)*

    1.2 (1.1-1.4)^

    1.3 (1.1-1.4)*

    1.3 (1.1-1.4)*

    1.3 (1.2-1.4)*

    1.2 (1.1-1.3)*

    PHA

    2.2 (1.5-3.1)*

    1.6 (1.0-2.4)^

    2.0 (1.5-2.6)*

    1.9 (1.4-2.6)*

    1.9 (1.5-2.4)*

    1.7 (1.4-2.1)*

    Table 1. Variables consistently SIG across all cohorts by UV and MV

    *p<0.001

    ^p<0.01

     

    Kerrie Davies, MSc1, Jody Lawrence, MD2, Claire Berry, MSc1, Georgina Davis, BSc1, Holly Yu, MSPH3, Bing Cai, PhD2, Elisa Gonzalez, MSc4, Ida Prantner, MD5, Andrea Kurcz, MD5, Ioana Macovei, MSc6, Hanna Pituch, PhD7, Elena Novakova, MD PhD8, Otakar Nyc, MD PhD9, Mathias Herrmann, MD10, Fabian Berger, MD10, Oliver Cornely, MD, FACP, FIDSA, FAAM11, Maria Vehreschild, MD11, Louise Pedneault, MD Msc FRCPC12 and Mark Wilcox, MD1, (1)University of Leeds, Leeds, United Kingdom, (2)Pfizer Vaccines Clinical Research & Development, Collegeville, PA, (3)Pfizer Global Innovative Pharma Business, Collegeville, PA, (4)Pfizer Inc., Collegeville, PA, (5)National Centre of Epidemiology, Budapest, Hungary, (6)Cantacuzino National Institute for Research, Bucharest, Romania, (7)Department of Medical Microbiology, Warsaw, Poland, (8)Institution Commenius University, Martin, Slovakia, (9)Department of Medical Microbiology, Prague, Czech Republic, (10)Institute of Medical Microbiology and Hygiene, Saarland, Germany, (11)University Hospital of Cologne, Cologne, Germany, (12)Pfizer Inc, New York, NY

    Disclosures:

    K. Davies, Sanofi Pasteur: Investigator , Research grant
    Astellas Pharm Europe: Investigator , Personal fees and Research grant
    bioMerieux: Investigator , Research grant
    Pfizer: Investigator , Research grant

    J. Lawrence, Pfizer Inc.: Employee , Salary

    C. Berry, Pfizer: Investigator , Research grant
    bioMerieux: Investigator , Research grant

    G. Davis, Sanofi Pasteur: Investigator , Research grant
    Astellas Pharma Europe: Investigator , Research grant
    bioMerieux: Investigator , Research grant
    Pfizer: Investigator , Research grant

    H. Yu, Pfizer Inc.: Employee , Salary

    B. Cai, Pfizer: Employee , Salary

    E. Gonzalez, Pfizer Inc.: Employee , Salary

    I. Prantner, None

    A. Kurcz, None

    I. Macovei, None

    H. Pituch, None

    E. Novakova, None

    O. Nyc, None

    M. Herrmann, None

    F. Berger, None

    O. Cornely, 3M: Investigator , Research grant and Research support
    Actelion: Investigator , Research grant and Research support
    Astellas: Consultant , Investigator and Speaker's Bureau , Consulting fee , Research grant and Research support
    AstraZeneca: Investigator , Research grant and Research support
    Basilea: Consultant , Investigator and Speaker's Bureau , Consulting fee , Research grant and Research support
    Bayer: Investigator , Research grant and Research support
    Celgene: Investigator , Research grant and Research support
    Cubist/Optimer: Investigator , Research grant and Research support
    Duke Univeristy (NIH UM1AI104681): Investigator , Research grant and Research support
    Genzyme: Investigator , Research grant and Research support
    Gilead: Consultant , Investigator and Speaker's Bureau , Consulting fee , Research grant and Research support
    GSK: Investigator , Research grant and Research support
    Leeds University: Investigator , Research grant and Research support
    Merck/MSD: Consultant , Investigator and Speaker's Bureau , Consulting fee , Research grant and Research support
    Miltenyi: Investigator , Research grant and Research support
    NanoMR: Investigator , Research grant and Research support
    Pfizer: Consultant , Investigator and Speaker's Bureau , Consulting fee , Research grant and Research support
    Quintiles: Investigator , Research grant and Research support
    Scynexis: Consultant and Investigator , Consulting fee , Research grant and Research support
    The Medicine Company: Investigator , Research grant and Research support
    Viropharma: Investigator , Research grant and Research support
    Amplyx: Consultant , Consulting fee
    Anacor: Consultant , Consulting fee
    Cidara: Consultant , Consulting fee
    DaVolterra: Consultant , Consulting fee
    Daiichi Sankyo: Consultant , Consulting fee
    F2G: Consultant , Consulting fee
    Genentech/Roche: Consultant , Consulting fee
    Matinas: Consultant , Consulting fee
    MedPace: Consultant , Consulting fee
    Merck Serono: Consultant , Consulting fee
    Sanofi Pasteur: Consultant , Consulting fee
    Seres: Consultant , Consulting fee
    Summit: Consultant , Consulting fee
    Vical: Consultant , Consulting fee
    Vifor: Consultant , Consulting fee
    The German Federal Ministry of Research and Education and the European Commission: Other , Financial/Material Support

    M. Vehreschild, Berlin Chemie: Consultant , Consulting fee
    MSD/Merck: Consultant and Speaker's Bureau , Consulting fee and Speaker honorarium
    Astellas Pharma: Consultant and Speaker's Bureau , Research grant
    Pfizer: Speaker's Bureau , Speaker honorarium
    Gilead Sciences: Speaker's Bureau , Research grant
    Organobalance: Speaker's Bureau , Speaker honorarium
    3M: Investigator , Research grant
    DaVolterra: Investigator , Research grant

    L. Pedneault, None

    M. Wilcox, Sanofi Pasteur: Investigator , Research grant
    Abbott Laboratories: Investigator , Personal fees and Research grant
    Actelion: Investigator , Personal fees and Research grant
    Astellas Pharma Europe: Investigator , Personal fees and Research grant
    Astra Zeneca: Other , Personal fees
    Bayer: Other , Personal fees
    bioMerieux: Investigator , Personal fees and Research grant
    Cerexa: Other , Personal fees
    Cubist: Investigator , Personal fees and Research grant
    Durata: Other , Personal fees
    The European Tissue Symposium: Investigator , Personal fees and Research grant
    The Medicines Company: Other , Personal fees
    MedImmune: Other , Personal fees
    Merck: Investigator , Personal fees and Research grant
    Motif Biosciences: Other , Personal fees
    Nabriva: Other , Personal fees
    Optimer: Other , Personal fees
    Paratek: Other , Personal fees
    Pfizer: Other , Personal fees
    Qiagen: Other , Personal fees
    Roche: Other , Personal fees
    Seres: Investigator , Personal fees and Research grant
    Summit: Investigator , Personal fees and Research grant
    Synthetic Biologics: Other , Personal fees
    Alere: Other , Personal fees
    DaVolterra: Investigator , Research grant

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.