{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T14:25:16Z","timestamp":1761488716587,"version":"build-2065373602"},"reference-count":21,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2012,1,6]],"date-time":"2012-01-06T00:00:00Z","timestamp":1325808000000},"content-version":"vor","delay-in-days":189,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2011,7]]},"abstract":"<jats:p><jats:bold>Study Objectives.<\/jats:bold> To determine the incidence of <jats:italic>Clostridium difficile<\/jats:italic> infection (CDI) at one community hospital by identifying patients with stool samples positive for <jats:italic>C. difficile<\/jats:italic> toxin A or B, and to compare the incidence with a 2008 national estimate; and to determine which patient characteristics and concomitant antimicrobial and acid\u2010suppression drugs are risk factors for the development of CDI.<\/jats:p><jats:p><jats:bold>Design.<\/jats:bold> Retrospective, single\u2010center, medical record review.<\/jats:p><jats:p><jats:bold>Setting.<\/jats:bold> 350\u2010bed community hospital.<\/jats:p><jats:p><jats:bold>Patients.<\/jats:bold> A total of 11,010 admissions between January 1, 2009, and December 31, 2009; 115 of these patients had stool samples positive for <jats:italic>C. difficile<\/jats:italic> toxin A or B.<\/jats:p><jats:p><jats:bold>Measurements and Main Results.<\/jats:bold> All <jats:italic>C. difficile<\/jats:italic> toxin A and B enzyme immunoassay tests were performed by a central laboratory. The incidence of CDI was 10.4 cases\/1000 patient admissions, which was significantly lower than the overall incidence reported in a 2008 national survey of 13.1 CDI cases\/1000 patient admissions (p=0.021). Demographic and clinical data of the patients with CDI were collected by using electronic medical records. Patients were more likely to be elderly and female, and to have developed CDI during hospitalization. Of the 115 patients, 95 (82.6%) received acid\u2010suppression therapy and 91 (79.1%) received antimicrobials. Of the patients receiving acid\u2010suppression therapy, 72 (75.8%) received a proton pump inhibitor during their hospitalization, and 49 (51.6%) received both a proton pump inhibitor and an antibiotic. The most frequently used antibiotics in this population were fluoroquinolones, cephalosporins, and carbapenems, with a significantly larger proportion of patients who received carbapenems developing CDI compared with the other classes of antibiotics (p&lt;0.05 for both comparisons). Patients receiving antimicrobial and acid\u2010suppression therapy were more likely to develop CDI than those who did not receive these drugs.<\/jats:p><jats:p><jats:bold>Conclusion.<\/jats:bold> The incidence of CDI in 2009 at one community hospital was significantly lower than a 2008 national estimate. Antimicrobial and acid\u2010suppression therapies\u2014in particular, combinations of fluoroquinolones, cephalosporins, carbapenems, and proton pump inhibitors\u2014were found to be risk factors for the development of CDIs in hospitalized patients.<\/jats:p>","DOI":"10.1592\/phco.31.7.642","type":"journal-article","created":{"date-parts":[[2011,6,25]],"date-time":"2011-06-25T15:22:01Z","timestamp":1309015321000},"page":"642-648","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Incidence of <i>Clostridium difficile<\/i> Infections in Patients Receiving Antimicrobial and Acid\u2010Suppression Therapy"],"prefix":"10.1002","volume":"31","author":[{"given":"Rachel N.","family":"King","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie L.","family":"Lager","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2012,1,6]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.1086\/651706"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.171"},{"key":"e_1_2_1_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01666909"},{"key":"e_1_2_1_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra0707500"},{"key":"e_1_2_1_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp011603"},{"key":"e_1_2_1_7_2","doi-asserted-by":"publisher","DOI":"10.1086\/524320"},{"key":"e_1_2_1_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2009.01.001"},{"key":"e_1_2_1_9_2","doi-asserted-by":"publisher","DOI":"10.1086\/596703"},{"key":"e_1_2_1_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/24.3.324"},{"key":"e_1_2_1_11_2","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.1040876"},{"key":"e_1_2_1_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2008.01975.x"},{"key":"e_1_2_1_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0195-6701(03)00088-4"},{"key":"e_1_2_1_14_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2010.73"},{"key":"e_1_2_1_15_2","doi-asserted-by":"crossref","first-page":"409","DOI":"10.3201\/eid1203.051064","article-title":"Clostridium difficile infection in patients discharged from U.S. short\u2010stay hospitals, 1996\u20132003","volume":"12","author":"McDonald LC","year":"2006","journal-title":"Emerg Infect Dis"},{"key":"e_1_2_1_16_2","unstructured":"ElixhauserA. JhungM.Clostridium difficile\u2010associated disease in U.S. hospitals 1993\u20132005. Healthcare cost and utilization project (HCUP) statistical brief no. 50 April 2008. Available fromhttp:www.hcup\u2010us.ahrq.govreportsstatbriefssb50.pdf. Accessed May 25 2010."},{"key":"e_1_2_1_17_2","doi-asserted-by":"publisher","DOI":"10.1086\/511798"},{"key":"e_1_2_1_18_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2010.89"},{"key":"e_1_2_1_19_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2009.04229.x"},{"key":"e_1_2_1_20_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrgastro.2009.128"},{"key":"e_1_2_1_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3181c1ce3d"},{"key":"e_1_2_1_22_2","doi-asserted-by":"publisher","DOI":"10.1086\/521863"}],"container-title":["Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1592%2Fphco.31.7.642","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1592\/phco.31.7.642","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T16:10:37Z","timestamp":1761063037000},"score":1,"resource":{"primary":{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/10.1592\/phco.31.7.642"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,7]]},"references-count":21,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2011,7]]}},"alternative-id":["10.1592\/phco.31.7.642"],"URL":"https:\/\/doi.org\/10.1592\/phco.31.7.642","archive":["Portico"],"relation":{},"ISSN":["0277-0008","1875-9114"],"issn-type":[{"type":"print","value":"0277-0008"},{"type":"electronic","value":"1875-9114"}],"subject":[],"published":{"date-parts":[[2011,7]]},"assertion":[{"value":"2012-01-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}