Epidemiology and Recurrence Rates of Clostridium difficile Infections in Germany: A Secondary Data Analysis

Introduction Clostridiumdifficile infection (CDI) is the most common cause of health-care-associated infectious diarrhea. Recurrence rates are as high as 20–30% after standard treatment with metronidazole or vancomycin, and appear to be reduced for patients treated with fidaxomicin. According to the literature, the risk of CDI recurrence increases after the second relapse to 30–65%. Accurate data for Germany are not yet available. Methods Based on the research database of arvato health analytics (Munich, Germany), a secondary data analysis for the incidence, treatment characteristics and course of CDI was performed. The database included high granular accounting information of about 1.46 million medically insured patients covering the period 2006–2013, being representative for Germany. The analysis was based on new-onset CDI in 2012 in patients which either received outpatient antibiotic therapy for CDI or were hospitalized. Results The ICD-10 coded incidence of CDI in 2012 was 83 cases per 100,000 population. Overall mortality rates within the follow-up period of 1 year were 13.5% in inpatients with primary diagnosis of CDI, compared to 24.3% in inpatients with secondary diagnosis of CDI (P < 0.001), and 7.1% in outpatients (P < 0.001). In the median, patients with secondary diagnosis of CDI remained significantly longer hospitalized (24 vs. 9 days, P < 0.001). First recurrence of CDI was observed in 18.2% of cases with index events. There was a significantly increased risk to suffer a second and third recurrence, reaching 28.4% (P < 0.001), and 30.2% (P = 0.017), respectively. Antibiotic therapy of CDI in outpatients was performed mainly with metronidazole (in 90.8% of index events, 60.0% of first recurrences, and 43.5% of second recurrences). Conclusion The reported incidence of CDI in Germany is higher than noted previously. The recurrence rates do increase with the number of relapses, but are lower than reported in the literature, despite dominance of metronidazole treatment in outpatients. Funding MSD Sharp & Dohme GmbH, Haar, Germany. Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Lübbert, Christoph [verfasserIn] Zimmermann, Lisa [verfasserIn] Borchert, Julia [verfasserIn] Hörner, Bernd [verfasserIn] Mutters, Reinier [verfasserIn] Rodloff, Arne C. [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2016

Schlagwörter:	Antibiotic treatment infection Germany Incidence Recurrence Societal burden

Übergeordnetes Werk:	Enthalten in: Infectious diseases and therapy - Heidelberg : Springer, 2012, 5(2016), 4 vom: 21. Okt., Seite 545-554
Übergeordnetes Werk:	volume:5 ; year:2016 ; number:4 ; day:21 ; month:10 ; pages:545-554

Links:	Volltext

DOI / URN:	10.1007/s40121-016-0135-9

Katalog-ID:	SPR03287961X

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520			\|a Introduction Clostridiumdifficile infection (CDI) is the most common cause of health-care-associated infectious diarrhea. Recurrence rates are as high as 20–30% after standard treatment with metronidazole or vancomycin, and appear to be reduced for patients treated with fidaxomicin. According to the literature, the risk of CDI recurrence increases after the second relapse to 30–65%. Accurate data for Germany are not yet available. Methods Based on the research database of arvato health analytics (Munich, Germany), a secondary data analysis for the incidence, treatment characteristics and course of CDI was performed. The database included high granular accounting information of about 1.46 million medically insured patients covering the period 2006–2013, being representative for Germany. The analysis was based on new-onset CDI in 2012 in patients which either received outpatient antibiotic therapy for CDI or were hospitalized. Results The ICD-10 coded incidence of CDI in 2012 was 83 cases per 100,000 population. Overall mortality rates within the follow-up period of 1 year were 13.5% in inpatients with primary diagnosis of CDI, compared to 24.3% in inpatients with secondary diagnosis of CDI (P < 0.001), and 7.1% in outpatients (P < 0.001). In the median, patients with secondary diagnosis of CDI remained significantly longer hospitalized (24 vs. 9 days, P < 0.001). First recurrence of CDI was observed in 18.2% of cases with index events. There was a significantly increased risk to suffer a second and third recurrence, reaching 28.4% (P < 0.001), and 30.2% (P = 0.017), respectively. Antibiotic therapy of CDI in outpatients was performed mainly with metronidazole (in 90.8% of index events, 60.0% of first recurrences, and 43.5% of second recurrences). Conclusion The reported incidence of CDI in Germany is higher than noted previously. The recurrence rates do increase with the number of relapses, but are lower than reported in the literature, despite dominance of metronidazole treatment in outpatients. Funding MSD Sharp & Dohme GmbH, Haar, Germany.
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allfields	10.1007/s40121-016-0135-9 doi (DE-627)SPR03287961X (SPR)s40121-016-0135-9-e DE-627 ger DE-627 rakwb eng 610 ASE Lübbert, Christoph verfasserin aut Epidemiology and Recurrence Rates of Clostridium difficile Infections in Germany: A Secondary Data Analysis 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction Clostridiumdifficile infection (CDI) is the most common cause of health-care-associated infectious diarrhea. Recurrence rates are as high as 20–30% after standard treatment with metronidazole or vancomycin, and appear to be reduced for patients treated with fidaxomicin. According to the literature, the risk of CDI recurrence increases after the second relapse to 30–65%. Accurate data for Germany are not yet available. Methods Based on the research database of arvato health analytics (Munich, Germany), a secondary data analysis for the incidence, treatment characteristics and course of CDI was performed. The database included high granular accounting information of about 1.46 million medically insured patients covering the period 2006–2013, being representative for Germany. The analysis was based on new-onset CDI in 2012 in patients which either received outpatient antibiotic therapy for CDI or were hospitalized. Results The ICD-10 coded incidence of CDI in 2012 was 83 cases per 100,000 population. Overall mortality rates within the follow-up period of 1 year were 13.5% in inpatients with primary diagnosis of CDI, compared to 24.3% in inpatients with secondary diagnosis of CDI (P < 0.001), and 7.1% in outpatients (P < 0.001). In the median, patients with secondary diagnosis of CDI remained significantly longer hospitalized (24 vs. 9 days, P < 0.001). First recurrence of CDI was observed in 18.2% of cases with index events. There was a significantly increased risk to suffer a second and third recurrence, reaching 28.4% (P < 0.001), and 30.2% (P = 0.017), respectively. Antibiotic therapy of CDI in outpatients was performed mainly with metronidazole (in 90.8% of index events, 60.0% of first recurrences, and 43.5% of second recurrences). Conclusion The reported incidence of CDI in Germany is higher than noted previously. The recurrence rates do increase with the number of relapses, but are lower than reported in the literature, despite dominance of metronidazole treatment in outpatients. Funding MSD Sharp & Dohme GmbH, Haar, Germany. Antibiotic treatment (dpeaa)DE-He213 infection (dpeaa)DE-He213 Germany (dpeaa)DE-He213 Incidence (dpeaa)DE-He213 Recurrence (dpeaa)DE-He213 Societal burden (dpeaa)DE-He213 Zimmermann, Lisa verfasserin aut Borchert, Julia verfasserin aut Hörner, Bernd verfasserin aut Mutters, Reinier verfasserin aut Rodloff, Arne C. verfasserin aut Enthalten in Infectious diseases and therapy Heidelberg : Springer, 2012 5(2016), 4 vom: 21. Okt., Seite 545-554 (DE-627)735690766 (DE-600)2701611-0 2193-6382 nnns volume:5 year:2016 number:4 day:21 month:10 pages:545-554 https://dx.doi.org/10.1007/s40121-016-0135-9 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 5 2016 4 21 10 545-554
spelling	10.1007/s40121-016-0135-9 doi (DE-627)SPR03287961X (SPR)s40121-016-0135-9-e DE-627 ger DE-627 rakwb eng 610 ASE Lübbert, Christoph verfasserin aut Epidemiology and Recurrence Rates of Clostridium difficile Infections in Germany: A Secondary Data Analysis 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction Clostridiumdifficile infection (CDI) is the most common cause of health-care-associated infectious diarrhea. Recurrence rates are as high as 20–30% after standard treatment with metronidazole or vancomycin, and appear to be reduced for patients treated with fidaxomicin. According to the literature, the risk of CDI recurrence increases after the second relapse to 30–65%. Accurate data for Germany are not yet available. Methods Based on the research database of arvato health analytics (Munich, Germany), a secondary data analysis for the incidence, treatment characteristics and course of CDI was performed. The database included high granular accounting information of about 1.46 million medically insured patients covering the period 2006–2013, being representative for Germany. The analysis was based on new-onset CDI in 2012 in patients which either received outpatient antibiotic therapy for CDI or were hospitalized. Results The ICD-10 coded incidence of CDI in 2012 was 83 cases per 100,000 population. Overall mortality rates within the follow-up period of 1 year were 13.5% in inpatients with primary diagnosis of CDI, compared to 24.3% in inpatients with secondary diagnosis of CDI (P < 0.001), and 7.1% in outpatients (P < 0.001). In the median, patients with secondary diagnosis of CDI remained significantly longer hospitalized (24 vs. 9 days, P < 0.001). First recurrence of CDI was observed in 18.2% of cases with index events. There was a significantly increased risk to suffer a second and third recurrence, reaching 28.4% (P < 0.001), and 30.2% (P = 0.017), respectively. Antibiotic therapy of CDI in outpatients was performed mainly with metronidazole (in 90.8% of index events, 60.0% of first recurrences, and 43.5% of second recurrences). Conclusion The reported incidence of CDI in Germany is higher than noted previously. The recurrence rates do increase with the number of relapses, but are lower than reported in the literature, despite dominance of metronidazole treatment in outpatients. Funding MSD Sharp & Dohme GmbH, Haar, Germany. Antibiotic treatment (dpeaa)DE-He213 infection (dpeaa)DE-He213 Germany (dpeaa)DE-He213 Incidence (dpeaa)DE-He213 Recurrence (dpeaa)DE-He213 Societal burden (dpeaa)DE-He213 Zimmermann, Lisa verfasserin aut Borchert, Julia verfasserin aut Hörner, Bernd verfasserin aut Mutters, Reinier verfasserin aut Rodloff, Arne C. verfasserin aut Enthalten in Infectious diseases and therapy Heidelberg : Springer, 2012 5(2016), 4 vom: 21. Okt., Seite 545-554 (DE-627)735690766 (DE-600)2701611-0 2193-6382 nnns volume:5 year:2016 number:4 day:21 month:10 pages:545-554 https://dx.doi.org/10.1007/s40121-016-0135-9 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 5 2016 4 21 10 545-554
allfields_unstemmed	10.1007/s40121-016-0135-9 doi (DE-627)SPR03287961X (SPR)s40121-016-0135-9-e DE-627 ger DE-627 rakwb eng 610 ASE Lübbert, Christoph verfasserin aut Epidemiology and Recurrence Rates of Clostridium difficile Infections in Germany: A Secondary Data Analysis 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction Clostridiumdifficile infection (CDI) is the most common cause of health-care-associated infectious diarrhea. Recurrence rates are as high as 20–30% after standard treatment with metronidazole or vancomycin, and appear to be reduced for patients treated with fidaxomicin. According to the literature, the risk of CDI recurrence increases after the second relapse to 30–65%. Accurate data for Germany are not yet available. Methods Based on the research database of arvato health analytics (Munich, Germany), a secondary data analysis for the incidence, treatment characteristics and course of CDI was performed. The database included high granular accounting information of about 1.46 million medically insured patients covering the period 2006–2013, being representative for Germany. The analysis was based on new-onset CDI in 2012 in patients which either received outpatient antibiotic therapy for CDI or were hospitalized. Results The ICD-10 coded incidence of CDI in 2012 was 83 cases per 100,000 population. Overall mortality rates within the follow-up period of 1 year were 13.5% in inpatients with primary diagnosis of CDI, compared to 24.3% in inpatients with secondary diagnosis of CDI (P < 0.001), and 7.1% in outpatients (P < 0.001). In the median, patients with secondary diagnosis of CDI remained significantly longer hospitalized (24 vs. 9 days, P < 0.001). First recurrence of CDI was observed in 18.2% of cases with index events. There was a significantly increased risk to suffer a second and third recurrence, reaching 28.4% (P < 0.001), and 30.2% (P = 0.017), respectively. Antibiotic therapy of CDI in outpatients was performed mainly with metronidazole (in 90.8% of index events, 60.0% of first recurrences, and 43.5% of second recurrences). Conclusion The reported incidence of CDI in Germany is higher than noted previously. The recurrence rates do increase with the number of relapses, but are lower than reported in the literature, despite dominance of metronidazole treatment in outpatients. Funding MSD Sharp & Dohme GmbH, Haar, Germany. Antibiotic treatment (dpeaa)DE-He213 infection (dpeaa)DE-He213 Germany (dpeaa)DE-He213 Incidence (dpeaa)DE-He213 Recurrence (dpeaa)DE-He213 Societal burden (dpeaa)DE-He213 Zimmermann, Lisa verfasserin aut Borchert, Julia verfasserin aut Hörner, Bernd verfasserin aut Mutters, Reinier verfasserin aut Rodloff, Arne C. verfasserin aut Enthalten in Infectious diseases and therapy Heidelberg : Springer, 2012 5(2016), 4 vom: 21. Okt., Seite 545-554 (DE-627)735690766 (DE-600)2701611-0 2193-6382 nnns volume:5 year:2016 number:4 day:21 month:10 pages:545-554 https://dx.doi.org/10.1007/s40121-016-0135-9 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 5 2016 4 21 10 545-554
allfieldsGer	10.1007/s40121-016-0135-9 doi (DE-627)SPR03287961X (SPR)s40121-016-0135-9-e DE-627 ger DE-627 rakwb eng 610 ASE Lübbert, Christoph verfasserin aut Epidemiology and Recurrence Rates of Clostridium difficile Infections in Germany: A Secondary Data Analysis 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction Clostridiumdifficile infection (CDI) is the most common cause of health-care-associated infectious diarrhea. Recurrence rates are as high as 20–30% after standard treatment with metronidazole or vancomycin, and appear to be reduced for patients treated with fidaxomicin. According to the literature, the risk of CDI recurrence increases after the second relapse to 30–65%. Accurate data for Germany are not yet available. Methods Based on the research database of arvato health analytics (Munich, Germany), a secondary data analysis for the incidence, treatment characteristics and course of CDI was performed. The database included high granular accounting information of about 1.46 million medically insured patients covering the period 2006–2013, being representative for Germany. The analysis was based on new-onset CDI in 2012 in patients which either received outpatient antibiotic therapy for CDI or were hospitalized. Results The ICD-10 coded incidence of CDI in 2012 was 83 cases per 100,000 population. Overall mortality rates within the follow-up period of 1 year were 13.5% in inpatients with primary diagnosis of CDI, compared to 24.3% in inpatients with secondary diagnosis of CDI (P < 0.001), and 7.1% in outpatients (P < 0.001). In the median, patients with secondary diagnosis of CDI remained significantly longer hospitalized (24 vs. 9 days, P < 0.001). First recurrence of CDI was observed in 18.2% of cases with index events. There was a significantly increased risk to suffer a second and third recurrence, reaching 28.4% (P < 0.001), and 30.2% (P = 0.017), respectively. Antibiotic therapy of CDI in outpatients was performed mainly with metronidazole (in 90.8% of index events, 60.0% of first recurrences, and 43.5% of second recurrences). Conclusion The reported incidence of CDI in Germany is higher than noted previously. The recurrence rates do increase with the number of relapses, but are lower than reported in the literature, despite dominance of metronidazole treatment in outpatients. Funding MSD Sharp & Dohme GmbH, Haar, Germany. Antibiotic treatment (dpeaa)DE-He213 infection (dpeaa)DE-He213 Germany (dpeaa)DE-He213 Incidence (dpeaa)DE-He213 Recurrence (dpeaa)DE-He213 Societal burden (dpeaa)DE-He213 Zimmermann, Lisa verfasserin aut Borchert, Julia verfasserin aut Hörner, Bernd verfasserin aut Mutters, Reinier verfasserin aut Rodloff, Arne C. verfasserin aut Enthalten in Infectious diseases and therapy Heidelberg : Springer, 2012 5(2016), 4 vom: 21. Okt., Seite 545-554 (DE-627)735690766 (DE-600)2701611-0 2193-6382 nnns volume:5 year:2016 number:4 day:21 month:10 pages:545-554 https://dx.doi.org/10.1007/s40121-016-0135-9 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 5 2016 4 21 10 545-554
allfieldsSound	10.1007/s40121-016-0135-9 doi (DE-627)SPR03287961X (SPR)s40121-016-0135-9-e DE-627 ger DE-627 rakwb eng 610 ASE Lübbert, Christoph verfasserin aut Epidemiology and Recurrence Rates of Clostridium difficile Infections in Germany: A Secondary Data Analysis 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction Clostridiumdifficile infection (CDI) is the most common cause of health-care-associated infectious diarrhea. Recurrence rates are as high as 20–30% after standard treatment with metronidazole or vancomycin, and appear to be reduced for patients treated with fidaxomicin. According to the literature, the risk of CDI recurrence increases after the second relapse to 30–65%. Accurate data for Germany are not yet available. Methods Based on the research database of arvato health analytics (Munich, Germany), a secondary data analysis for the incidence, treatment characteristics and course of CDI was performed. The database included high granular accounting information of about 1.46 million medically insured patients covering the period 2006–2013, being representative for Germany. The analysis was based on new-onset CDI in 2012 in patients which either received outpatient antibiotic therapy for CDI or were hospitalized. Results The ICD-10 coded incidence of CDI in 2012 was 83 cases per 100,000 population. Overall mortality rates within the follow-up period of 1 year were 13.5% in inpatients with primary diagnosis of CDI, compared to 24.3% in inpatients with secondary diagnosis of CDI (P < 0.001), and 7.1% in outpatients (P < 0.001). In the median, patients with secondary diagnosis of CDI remained significantly longer hospitalized (24 vs. 9 days, P < 0.001). First recurrence of CDI was observed in 18.2% of cases with index events. There was a significantly increased risk to suffer a second and third recurrence, reaching 28.4% (P < 0.001), and 30.2% (P = 0.017), respectively. Antibiotic therapy of CDI in outpatients was performed mainly with metronidazole (in 90.8% of index events, 60.0% of first recurrences, and 43.5% of second recurrences). Conclusion The reported incidence of CDI in Germany is higher than noted previously. The recurrence rates do increase with the number of relapses, but are lower than reported in the literature, despite dominance of metronidazole treatment in outpatients. Funding MSD Sharp & Dohme GmbH, Haar, Germany. Antibiotic treatment (dpeaa)DE-He213 infection (dpeaa)DE-He213 Germany (dpeaa)DE-He213 Incidence (dpeaa)DE-He213 Recurrence (dpeaa)DE-He213 Societal burden (dpeaa)DE-He213 Zimmermann, Lisa verfasserin aut Borchert, Julia verfasserin aut Hörner, Bernd verfasserin aut Mutters, Reinier verfasserin aut Rodloff, Arne C. verfasserin aut Enthalten in Infectious diseases and therapy Heidelberg : Springer, 2012 5(2016), 4 vom: 21. Okt., Seite 545-554 (DE-627)735690766 (DE-600)2701611-0 2193-6382 nnns volume:5 year:2016 number:4 day:21 month:10 pages:545-554 https://dx.doi.org/10.1007/s40121-016-0135-9 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 5 2016 4 21 10 545-554
language	English
source	Enthalten in Infectious diseases and therapy 5(2016), 4 vom: 21. Okt., Seite 545-554 volume:5 year:2016 number:4 day:21 month:10 pages:545-554
sourceStr	Enthalten in Infectious diseases and therapy 5(2016), 4 vom: 21. Okt., Seite 545-554 volume:5 year:2016 number:4 day:21 month:10 pages:545-554
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Antibiotic treatment infection Germany Incidence Recurrence Societal burden
dewey-raw	610
isfreeaccess_bool	true
container_title	Infectious diseases and therapy
authorswithroles_txt_mv	Lübbert, Christoph @@aut@@ Zimmermann, Lisa @@aut@@ Borchert, Julia @@aut@@ Hörner, Bernd @@aut@@ Mutters, Reinier @@aut@@ Rodloff, Arne C. @@aut@@
publishDateDaySort_date	2016-10-21T00:00:00Z
hierarchy_top_id	735690766
dewey-sort	3610
id	SPR03287961X
language_de	englisch
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Recurrence rates are as high as 20–30% after standard treatment with metronidazole or vancomycin, and appear to be reduced for patients treated with fidaxomicin. According to the literature, the risk of CDI recurrence increases after the second relapse to 30–65%. Accurate data for Germany are not yet available. Methods Based on the research database of arvato health analytics (Munich, Germany), a secondary data analysis for the incidence, treatment characteristics and course of CDI was performed. The database included high granular accounting information of about 1.46 million medically insured patients covering the period 2006–2013, being representative for Germany. The analysis was based on new-onset CDI in 2012 in patients which either received outpatient antibiotic therapy for CDI or were hospitalized. Results The ICD-10 coded incidence of CDI in 2012 was 83 cases per 100,000 population. Overall mortality rates within the follow-up period of 1 year were 13.5% in inpatients with primary diagnosis of CDI, compared to 24.3% in inpatients with secondary diagnosis of CDI (P < 0.001), and 7.1% in outpatients (P < 0.001). In the median, patients with secondary diagnosis of CDI remained significantly longer hospitalized (24 vs. 9 days, P < 0.001). First recurrence of CDI was observed in 18.2% of cases with index events. There was a significantly increased risk to suffer a second and third recurrence, reaching 28.4% (P < 0.001), and 30.2% (P = 0.017), respectively. Antibiotic therapy of CDI in outpatients was performed mainly with metronidazole (in 90.8% of index events, 60.0% of first recurrences, and 43.5% of second recurrences). Conclusion The reported incidence of CDI in Germany is higher than noted previously. 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author	Lübbert, Christoph
spellingShingle	Lübbert, Christoph ddc 610 misc Antibiotic treatment misc infection misc Germany misc Incidence misc Recurrence misc Societal burden Epidemiology and Recurrence Rates of Clostridium difficile Infections in Germany: A Secondary Data Analysis
authorStr	Lübbert, Christoph
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topic_title	610 ASE Epidemiology and Recurrence Rates of Clostridium difficile Infections in Germany: A Secondary Data Analysis Antibiotic treatment (dpeaa)DE-He213 infection (dpeaa)DE-He213 Germany (dpeaa)DE-He213 Incidence (dpeaa)DE-He213 Recurrence (dpeaa)DE-He213 Societal burden (dpeaa)DE-He213
topic	ddc 610 misc Antibiotic treatment misc infection misc Germany misc Incidence misc Recurrence misc Societal burden
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title	Epidemiology and Recurrence Rates of Clostridium difficile Infections in Germany: A Secondary Data Analysis
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title_full	Epidemiology and Recurrence Rates of Clostridium difficile Infections in Germany: A Secondary Data Analysis
author_sort	Lübbert, Christoph
journal	Infectious diseases and therapy
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author_browse	Lübbert, Christoph Zimmermann, Lisa Borchert, Julia Hörner, Bernd Mutters, Reinier Rodloff, Arne C.
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title_sort	epidemiology and recurrence rates of clostridium difficile infections in germany: a secondary data analysis
title_auth	Epidemiology and Recurrence Rates of Clostridium difficile Infections in Germany: A Secondary Data Analysis
abstract	Introduction Clostridiumdifficile infection (CDI) is the most common cause of health-care-associated infectious diarrhea. Recurrence rates are as high as 20–30% after standard treatment with metronidazole or vancomycin, and appear to be reduced for patients treated with fidaxomicin. According to the literature, the risk of CDI recurrence increases after the second relapse to 30–65%. Accurate data for Germany are not yet available. Methods Based on the research database of arvato health analytics (Munich, Germany), a secondary data analysis for the incidence, treatment characteristics and course of CDI was performed. The database included high granular accounting information of about 1.46 million medically insured patients covering the period 2006–2013, being representative for Germany. The analysis was based on new-onset CDI in 2012 in patients which either received outpatient antibiotic therapy for CDI or were hospitalized. Results The ICD-10 coded incidence of CDI in 2012 was 83 cases per 100,000 population. Overall mortality rates within the follow-up period of 1 year were 13.5% in inpatients with primary diagnosis of CDI, compared to 24.3% in inpatients with secondary diagnosis of CDI (P < 0.001), and 7.1% in outpatients (P < 0.001). In the median, patients with secondary diagnosis of CDI remained significantly longer hospitalized (24 vs. 9 days, P < 0.001). First recurrence of CDI was observed in 18.2% of cases with index events. There was a significantly increased risk to suffer a second and third recurrence, reaching 28.4% (P < 0.001), and 30.2% (P = 0.017), respectively. Antibiotic therapy of CDI in outpatients was performed mainly with metronidazole (in 90.8% of index events, 60.0% of first recurrences, and 43.5% of second recurrences). Conclusion The reported incidence of CDI in Germany is higher than noted previously. The recurrence rates do increase with the number of relapses, but are lower than reported in the literature, despite dominance of metronidazole treatment in outpatients. Funding MSD Sharp & Dohme GmbH, Haar, Germany.
abstractGer	Introduction Clostridiumdifficile infection (CDI) is the most common cause of health-care-associated infectious diarrhea. Recurrence rates are as high as 20–30% after standard treatment with metronidazole or vancomycin, and appear to be reduced for patients treated with fidaxomicin. According to the literature, the risk of CDI recurrence increases after the second relapse to 30–65%. Accurate data for Germany are not yet available. Methods Based on the research database of arvato health analytics (Munich, Germany), a secondary data analysis for the incidence, treatment characteristics and course of CDI was performed. The database included high granular accounting information of about 1.46 million medically insured patients covering the period 2006–2013, being representative for Germany. The analysis was based on new-onset CDI in 2012 in patients which either received outpatient antibiotic therapy for CDI or were hospitalized. Results The ICD-10 coded incidence of CDI in 2012 was 83 cases per 100,000 population. Overall mortality rates within the follow-up period of 1 year were 13.5% in inpatients with primary diagnosis of CDI, compared to 24.3% in inpatients with secondary diagnosis of CDI (P < 0.001), and 7.1% in outpatients (P < 0.001). In the median, patients with secondary diagnosis of CDI remained significantly longer hospitalized (24 vs. 9 days, P < 0.001). First recurrence of CDI was observed in 18.2% of cases with index events. There was a significantly increased risk to suffer a second and third recurrence, reaching 28.4% (P < 0.001), and 30.2% (P = 0.017), respectively. Antibiotic therapy of CDI in outpatients was performed mainly with metronidazole (in 90.8% of index events, 60.0% of first recurrences, and 43.5% of second recurrences). Conclusion The reported incidence of CDI in Germany is higher than noted previously. The recurrence rates do increase with the number of relapses, but are lower than reported in the literature, despite dominance of metronidazole treatment in outpatients. Funding MSD Sharp & Dohme GmbH, Haar, Germany.
abstract_unstemmed	Introduction Clostridiumdifficile infection (CDI) is the most common cause of health-care-associated infectious diarrhea. Recurrence rates are as high as 20–30% after standard treatment with metronidazole or vancomycin, and appear to be reduced for patients treated with fidaxomicin. According to the literature, the risk of CDI recurrence increases after the second relapse to 30–65%. Accurate data for Germany are not yet available. Methods Based on the research database of arvato health analytics (Munich, Germany), a secondary data analysis for the incidence, treatment characteristics and course of CDI was performed. The database included high granular accounting information of about 1.46 million medically insured patients covering the period 2006–2013, being representative for Germany. The analysis was based on new-onset CDI in 2012 in patients which either received outpatient antibiotic therapy for CDI or were hospitalized. Results The ICD-10 coded incidence of CDI in 2012 was 83 cases per 100,000 population. Overall mortality rates within the follow-up period of 1 year were 13.5% in inpatients with primary diagnosis of CDI, compared to 24.3% in inpatients with secondary diagnosis of CDI (P < 0.001), and 7.1% in outpatients (P < 0.001). In the median, patients with secondary diagnosis of CDI remained significantly longer hospitalized (24 vs. 9 days, P < 0.001). First recurrence of CDI was observed in 18.2% of cases with index events. There was a significantly increased risk to suffer a second and third recurrence, reaching 28.4% (P < 0.001), and 30.2% (P = 0.017), respectively. Antibiotic therapy of CDI in outpatients was performed mainly with metronidazole (in 90.8% of index events, 60.0% of first recurrences, and 43.5% of second recurrences). Conclusion The reported incidence of CDI in Germany is higher than noted previously. The recurrence rates do increase with the number of relapses, but are lower than reported in the literature, despite dominance of metronidazole treatment in outpatients. Funding MSD Sharp & Dohme GmbH, Haar, Germany.
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title_short	Epidemiology and Recurrence Rates of Clostridium difficile Infections in Germany: A Secondary Data Analysis
url	https://dx.doi.org/10.1007/s40121-016-0135-9
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author2	Zimmermann, Lisa Borchert, Julia Hörner, Bernd Mutters, Reinier Rodloff, Arne C.
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up_date	2024-07-03T15:15:44.558Z
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