PMID- 27677811
OWN - NLM
STAT- MEDLINE
DCOM- 20180130
LR  - 20240327
IS  - 1559-6834 (Electronic)
IS  - 0899-823X (Print)
IS  - 0899-823X (Linking)
VI  - 37
IP  - 12
DP  - 2016 Dec
TI  - Assessing the Risk of Hospital-Acquired Clostridium Difficile Infection With 
      Proton Pump Inhibitor Use: A Meta-Analysis.
PG  - 1408-1417
AB  - BACKGROUND Clostridium difficile is the principal infectious cause of 
      antibiotic-associated diarrhea and accounts for 12% of hospital-acquired 
      infections. Recent literature has shown an increased risk of C. difficile 
      infection (CDI) with proton pump inhibitor (PPI) use. OBJECTIVE To conduct a 
      systematic assessment of the risk of hospital-acquired CDI following exposure to 
      PPI. METHODS We searched multiple databases for studies examining the 
      relationship between PPI and hospital-acquired CDI. Pooled odds ratios were 
      generated and assessment for heterogeneity performed. RESULTS We found 23 
      observational studies involving 186,033 cases that met eligibility criteria. 
      Across studies, 10,307 cases of hospital-acquired CDI were reported. Significant 
      heterogeneity was present; therefore, a random effects model was used. The pooled 
      odds ratio was 1.81 (95% CI, 1.52-2.14), favoring higher risk of CDI with PPI 
      use. Significant heterogeneity was present, likely due to differences in 
      assessment of exposure, study population, and definition of CDI. DISCUSSION This 
      meta-analysis suggests PPIs significantly increase the risk of hospital-acquired 
      CDI. Given the significant health and economic burden of CDI and the risks of 
      PPI, optimization of PPI use should be included in a multifaceted approach to CDI 
      prevention. Infect Control Hosp Epidemiol 2016;1408-1417.
FAU - Arriola, Vanessa
AU  - Arriola V
AD  - 1Tulane University School of Public Health and Tropical Medicine,Department of 
      Epidemiology,New Orleans,Louisiana.
FAU - Tischendorf, Jessica
AU  - Tischendorf J
AD  - 2Department of Medicine,University of Wisconsin School of Medicine and Public 
      Health,Madison,Wisconsin.
FAU - Musuuza, Jackson
AU  - Musuuza J
AD  - 3Institute of Clinical and Translational Research,University of 
      Wisconsin,Madison,Wisconsin.
FAU - Barker, Anna
AU  - Barker A
AD  - 4University of Wisconsin School of Medicine and Public Health,Madison,Wisconsin.
FAU - Rozelle, Jeffrey W
AU  - Rozelle JW
AD  - 1Tulane University School of Public Health and Tropical Medicine,Department of 
      Epidemiology,New Orleans,Louisiana.
FAU - Safdar, Nasia
AU  - Safdar N
AD  - 2Department of Medicine,University of Wisconsin School of Medicine and Public 
      Health,Madison,Wisconsin.
LA  - eng
GR  - T32 GM008692/GM/NIGMS NIH HHS/United States
GR  - TL1 TR000429/TR/NCATS NIH HHS/United States
GR  - UL1 TR000427/TR/NCATS NIH HHS/United States
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20160928
PL  - United States
TA  - Infect Control Hosp Epidemiol
JT  - Infection control and hospital epidemiology
JID - 8804099
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Clostridioides difficile
MH  - Clostridium Infections/*epidemiology/*etiology
MH  - Cross Infection/*epidemiology/etiology/*microbiology
MH  - Diarrhea
MH  - Humans
MH  - Proton Pump Inhibitors/*adverse effects/therapeutic use
MH  - Risk Factors
PMC - PMC5657489
MID - NIHMS913569
EDAT- 2016/09/30 06:00
MHDA- 2018/01/31 06:00
PMCR- 2017/12/01
CRDT- 2016/09/29 06:00
PHST- 2016/09/30 06:00 [pubmed]
PHST- 2018/01/31 06:00 [medline]
PHST- 2016/09/29 06:00 [entrez]
PHST- 2017/12/01 00:00 [pmc-release]
AID - S0899823X1600194X [pii]
AID - 10.1017/ice.2016.194 [doi]
PST - ppublish
SO  - Infect Control Hosp Epidemiol. 2016 Dec;37(12):1408-1417. doi: 
      10.1017/ice.2016.194. Epub 2016 Sep 28.