Identification of novel risk factors for community-acquired Clostridium difficile infection using spatial statistics and geographic information system analyses.

Identification of novel risk factors for community-acquired Clostridium difficile infection using spatial statistics and geographic information system analyses.

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BackgroundThe rate of community-acquired Clostridium difficile infection (CA-CDI) is increasing.While receipt of antibiotics kenya tree coral for sale remains an important risk factor for CDI, studies related to acquisition of C.difficile outside of hospitals are lacking.As a result, risk factors for exposure to C.

difficile in community settings have been inadequately studied.Main objectiveTo identify novel environmental risk factors for CA-CDI.MethodsWe performed a population-based retrospective cohort study of patients with CA-CDI from 1/1/2007 through 12/31/2014 in a 10-county area in central North Carolina.360 Census Tracts in these 10 counties were used as the demographic Geographic Information System (GIS) base-map.

Longitude and latitude (X, Y) coordinates were generated from patient home addresses and overlaid to Census Tracts polygons using ArcGIS; ArcView was used to assess "hot-spots" or clusters rawafricaonline.com of CA-CDI.We then constructed a mixed hierarchical model to identify environmental variables independently associated with increased rates of CA-CDI.ResultsA total of 1,895 unique patients met our criteria for CA-CDI.The mean patient age was 54.

5 years; 62% were female and 70% were Caucasian.402 (21%) patient addresses were located in "hot spots" or clusters of CA-CDI (pConclusionsOur study is the first to use spatial statistics and mixed models to identify important environmental risk factors for acquisition of C.difficile and adds to the growing evidence that farm practices may put patients at risk for important drug-resistant infections.