{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,30]],"date-time":"2025-08-30T16:59:46Z","timestamp":1756573186496,"version":"3.37.3"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2023,7,6]],"date-time":"2023-07-06T00:00:00Z","timestamp":1688601600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100007037","name":"Danish Ministry of Health","doi-asserted-by":"publisher","award":["1608967"],"award-info":[{"award-number":["1608967"]}],"id":[{"id":"10.13039\/501100007037","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100024075","name":"Region of Southern Denmark","doi-asserted-by":"publisher","award":["17\/15637"],"award-info":[{"award-number":["17\/15637"]}],"id":[{"id":"10.13039\/501100024075","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,8,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Clostridioides difficile infection is an urgent public health threat, and the incidence has been increasing over the last decades. Knowledge of the prevalence of C. difficile in acutely admitted patients and risk factors for colonization with C. difficile assists emergency departments (EDs) in prioritizing preventive initiatives. This national study aimed to describe prevalence and risk factors for C. difficile carriers acutely admitted to EDs, focusing on the impact of earlier antibiotic prescription.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a nationwide analytic cross-sectional study with prospective data collection combined with a nested case\u2013control study with retrospective data collection. All adults visiting one of eight Danish EDs were interviewed and examined for C. difficile. Using a national register, we collected the antibiotic history within the 2 years prior to enrolment. The primary outcome was the prevalence of C. difficile colonization, and secondary outcomes were related to risk factors and prior antibiotic prescription. Multivariate analyses examined the association between earlier antibiotic prescription and C. difficile colonization.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 5019 participants, 89 were colonized with C. difficile (prevalence of 1.8%). A significant and exposure-dependent association was found for penicillins [DDD\/person-year(PY)\u200a&amp;gt;\u200a20; OR 4.93 (95% CI 2.22\u201310.97)] and fluoroquinolones [DDD\/PY\u200a&amp;gt;\u200a20; OR 8.81 (95% CI 2.54\u201330.55)], but not macrolides. Timing of the prescription did not affect the association.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>One out of 55 patients visiting a Danish ED were colonized with C. difficile. Risk factors for colonization included high age, comorbidity and prior prescription of fluoroquinolones and penicillins.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jac\/dkad213","type":"journal-article","created":{"date-parts":[[2023,7,6]],"date-time":"2023-07-06T10:10:13Z","timestamp":1688638213000},"page":"2089-2096","source":"Crossref","is-referenced-by-count":7,"title":["Carrier prevalence of <i>Clostridioides difficile<\/i> in emergency departments and the association of prior antibiotic consumption: a combined cross-sectional and nested case\u2013control study"],"prefix":"10.1093","volume":"78","author":[{"given":"Helene","family":"Skj\u00f8t-Arkil","sequence":"first","affiliation":[{"name":"Department of Regional Health Research at University of Southern Denmark , Aabenraa , Denmark"},{"name":"Emergency Department at University Hospital of Southern Denmark , Aabenraa , Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kumanan","family":"Rune Nanthan","sequence":"additional","affiliation":[{"name":"Emergency Department at University Hospital of Southern Denmark , Aabenraa , Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5393-1103","authenticated-orcid":false,"given":"Ming","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Microbiology at University Hospital of Southern Denmark , Aabenraa , Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2129-328X","authenticated-orcid":false,"given":"Flemming S","family":"Rosenvinge","sequence":"additional","affiliation":[{"name":"Department of Clinical Microbiology at Odense University Hospital, and Research Unit of Clinical Microbiology at University of Southern Denmark , Odense , Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,7,6]]},"reference":[{"key":"2023080202252038800_dkad213-B1","article-title":"Global burden of Clostridium difficile infections: a systematic review and meta-analysis","volume":"9","author":"Balsells","year":"2019","journal-title":"J Glob Health"},{"key":"2023080202252038800_dkad213-B2","doi-asserted-by":"crossref","DOI":"10.1128\/CMR.00021-17","article-title":"Understanding Clostridium difficile colonization","volume":"31","author":"Crobach","year":"2018","journal-title":"Clin Microbiol Rev"},{"key":"2023080202252038800_dkad213-B3","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/S0140-6736(10)61266-4","article-title":"Clostridium difficile infection in Europe: a hospital-based 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