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Seasonal variations in Clostridium difficile infections are associated with influenza and respiratory syncytial virus activity independently of antibiotic prescriptions: a time series analysis in Quebec, Canada.
Antimicrob Agents Chemother. 2012 Feb; 56(2):639-46.AA

Abstract

Seasonal variations in Clostridium difficile-associated diarrhea (CDAD), with a higher incidence occurring during winter months, have been reported. Although winter epidemics of respiratory viruses may be temporally associated with an increase in CDAD morbidity, we hypothesized that this association is mainly due to increased antibiotic use for respiratory infections. The objective of this study was to evaluate the effect of the two most frequent respiratory viruses (influenza virus and respiratory syncytial virus [RSV]) and antibiotics prescribed for respiratory infections (fluoroquinolones and macrolides) on the CDAD incidence in hospitals in the province of Québec, Canada. A multivariable Box-Jenkins transfer function model was built to relate monthly CDAD incidence to the monthly percentage of positive tests for influenza virus and RSV and monthly fluoroquinolone and macrolide prescriptions over a 4-year period (January 2005 to December 2008). Analysis showed that temporal variations in CDAD incidence followed temporal variations for influenza virus (P = 0.043), RSV (P = 0.004), and macrolide prescription (P = 0.05) time series with an average delay of 1 month and fluoroquinolone prescription time series with an average delay of 2 months (P = 0.01). We conclude that influenza virus and RSV circulation is independently associated with CDAD incidence after controlling for fluoroquinolone and macrolide use. This association was observed at an aggregated level and may be indicative of other phenomena occurring during wintertime.

Authors+Show Affiliations

Institut National de Santé Publique du Québec, Québec, Canada. rodica.gilca@ssss.gouv.qc.caNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22106208

Citation

Gilca, Rodica, et al. "Seasonal Variations in Clostridium Difficile Infections Are Associated With Influenza and Respiratory Syncytial Virus Activity Independently of Antibiotic Prescriptions: a Time Series Analysis in Quebec, Canada." Antimicrobial Agents and Chemotherapy, vol. 56, no. 2, 2012, pp. 639-46.
Gilca R, Fortin E, Frenette C, et al. Seasonal variations in Clostridium difficile infections are associated with influenza and respiratory syncytial virus activity independently of antibiotic prescriptions: a time series analysis in Quebec, Canada. Antimicrob Agents Chemother. 2012;56(2):639-46.
Gilca, R., Fortin, E., Frenette, C., Longtin, Y., & Gourdeau, M. (2012). Seasonal variations in Clostridium difficile infections are associated with influenza and respiratory syncytial virus activity independently of antibiotic prescriptions: a time series analysis in Quebec, Canada. Antimicrobial Agents and Chemotherapy, 56(2), 639-46. https://doi.org/10.1128/AAC.05411-11
Gilca R, et al. Seasonal Variations in Clostridium Difficile Infections Are Associated With Influenza and Respiratory Syncytial Virus Activity Independently of Antibiotic Prescriptions: a Time Series Analysis in Quebec, Canada. Antimicrob Agents Chemother. 2012;56(2):639-46. PubMed PMID: 22106208.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Seasonal variations in Clostridium difficile infections are associated with influenza and respiratory syncytial virus activity independently of antibiotic prescriptions: a time series analysis in Quebec, Canada. AU - Gilca,Rodica, AU - Fortin,Elise, AU - Frenette,Charles, AU - Longtin,Yves, AU - Gourdeau,Marie, Y1 - 2011/11/21/ PY - 2011/11/23/entrez PY - 2011/11/23/pubmed PY - 2012/5/26/medline SP - 639 EP - 46 JF - Antimicrobial agents and chemotherapy JO - Antimicrob Agents Chemother VL - 56 IS - 2 N2 - Seasonal variations in Clostridium difficile-associated diarrhea (CDAD), with a higher incidence occurring during winter months, have been reported. Although winter epidemics of respiratory viruses may be temporally associated with an increase in CDAD morbidity, we hypothesized that this association is mainly due to increased antibiotic use for respiratory infections. The objective of this study was to evaluate the effect of the two most frequent respiratory viruses (influenza virus and respiratory syncytial virus [RSV]) and antibiotics prescribed for respiratory infections (fluoroquinolones and macrolides) on the CDAD incidence in hospitals in the province of Québec, Canada. A multivariable Box-Jenkins transfer function model was built to relate monthly CDAD incidence to the monthly percentage of positive tests for influenza virus and RSV and monthly fluoroquinolone and macrolide prescriptions over a 4-year period (January 2005 to December 2008). Analysis showed that temporal variations in CDAD incidence followed temporal variations for influenza virus (P = 0.043), RSV (P = 0.004), and macrolide prescription (P = 0.05) time series with an average delay of 1 month and fluoroquinolone prescription time series with an average delay of 2 months (P = 0.01). We conclude that influenza virus and RSV circulation is independently associated with CDAD incidence after controlling for fluoroquinolone and macrolide use. This association was observed at an aggregated level and may be indicative of other phenomena occurring during wintertime. SN - 1098-6596 UR - https://www.unboundmedicine.com/medline/citation/22106208/Seasonal_variations_in_Clostridium_difficile_infections_are_associated_with_influenza_and_respiratory_syncytial_virus_activity_independently_of_antibiotic_prescriptions:_a_time_series_analysis_in_Quebec_Canada_ L2 - http://aac.asm.org/cgi/pmidlookup?view=long&pmid=22106208 DB - PRIME DP - Unbound Medicine ER -