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Flooding and Clostridium difficile Infection

A Case-Crossover Analysis

Bibliographic Data

ID15463124
AuthorsCynthia J Lin (0000-0002-1221-2401, University of North Carolina at Chapel Hill), Cynthia Lin (University of North Carolina, Gillings School of Global Public Health, Department of Epidemiology, Chapel Hill, NC 27599, USA), Timothy J Wade (0000-0002-7843-0997, Environmental Protection Agency, corresponding author), Timothy Wade (USA Environmental Protection Agency (EPA), Office of Research and Development, National Health and Environmental Effects Research Laboratory, Environmental Public Health Division, Research Triangle Park, NC 27709, USA), Elizabeth D Hilborn (0000-0002-3035-3101, Environmental Protection Agency), Elizabeth Hilborn (USA Environmental Protection Agency (EPA), Office of Research and Development, National Health and Environmental Effects Research Laboratory, Environmental Public Health Division, Research Triangle Park, NC 27709, USA)
Year2015
Volume12
Issue6
Pages6948-6964
Publication date2015-06-17
Open AccessYes
TypeARTICLE
VenueInternational Journal of Environmental Research and Public Health (JOURNAL)
Journal identifiersISSN: 1661-7827 • E-ISSN: 1660-4601
PublisherMultidisciplinary Digital Publishing Institute (PUBLISHER • CH)
DOI10.3390/ijerph120606948
PMID26090609
PMCIDPMC4483742
OpenAlexW1586619515
LanguageEN
Citations received3
References cited59

Clostridium difficile is a bacterium that can spread by water. It often causes acute gastrointestinal illness in older adults who are hospitalized and/or receiving antibiotics; however, community-associated infections affecting otherwise healthy individuals have become more commonly reported. A case-crossover study was used to assess emergency room (ER) and outpatient visits for C. difficile infection following flood events in Massachusetts from 2003 through 2007. Exposure status was based on whether or not a flood occurred prior to the case/control date during the following risk periods: 0-6 days, 7-13 days, 14-20 days, and 21-27 days. Fixed-effects logistic regression was used to estimate the risk of diagnosis with C. difficile infection following a flood. There were 129 flood events and 1575 diagnoses of C. difficile infection. Among working age adults (19-64 years), ER and outpatient visits for C. difficile infection were elevated during the 7-13 days following a flood (Odds Ratio, OR = 1.69; 95% Confidence Interval, CI: 0.84, 3.37). This association was more substantial among males (OR = 3.21; 95% CI: 1.01-10.19). Associations during other risk periods were not observed (p < 0.05). Although we were unable to differentiate community-associated versus nosocomial infections, a potential increase in C. difficile infections should be considered as more flooding is projected due to climate change

Antibiotics · Biology · Clostridium difficile · Confidence interval · Emergency department · Logistic regression · Odds ratio · Clostridium difficile and Clostridium perfringens research · Healthcare cost, quality, practices · Medicine · Nosocomial Infections in ICU · Emergency Medicine · Internal Medicine · Microbiology

  • Flooding and emergency department visits

    Open Access•Balaji Ramesh, Meredith A Jagger et al.•International Journal of Disaster…•2022

  • Monitoring the evolution of individuals’ flood-related adaptive behaviors over time

    Open Access•Pierre Valois, Maxime Tessier et al.•BMC Public Health•2020

  • Development and validation of five behavioral indices of flood adaptation

    Open Access•Pierre Valois, Maxime Caron et al.•BMC Public Health•2019

  • Case???Crossover Analyses of Air Pollution Exposure Data

    Holly Janes, Lianne Sheppard et al.•Epidemiology•2005

  • Climate change and human health

    Open Access•Anthony J Mcmichael, Rosalie E Woodruff et al.•The Lancet•2006

  • Increasing risk of great floods in a changing climate

    Open Access•P C D Milly, R T Wetherald et al.•Nature•2002

  • Floods and human health

    Open Access•Katarzyna Alderman, Lyle R Turner et al.•Environment International•2012

  • The Case-Crossover Design

    Malcolm Maclure•American Journal of Epidemiology•1991

Citations per year0.43
Citation span2019 - 2022 (4)
Highly citedNo

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