title: Hospital-acquired Clostridium difficile diarrhoea and herd immunity.
abstract: Clostridium difficile diarrhoea represents a significant health-service burden. We recently experienced an outbreak of C difficile diarrhoea associated with increased use of cefotaxime. The question we pose in this paper is how did the introduction and withdrawal of a single antibiotic so greatly affect rates of C difficile diarrhoea? Other antibiotics had nearly as high a risk of causing diarrhoea as cefotaxime, and the majority of patients never received cefotaxime. We believe that such outbreaks of C difficile diarrhoea are best understood in terms of a population model, and that taking antibiotics like cefotaxime should be thought of as a population rather than an individual risk factor. We postulate a herd-immunity model of C difficile diarrhoea, and examine the implications of this hypothesis.
authors.affiliation: Department of Geriatric Medicine, University of Edinburgh, Royal Victoria Hospital, UK.
authors.forename: J M
authors.initials: JM
authors.lastname: Starr
authors.forename: T R
authors.initials: TR
authors.lastname: Rogers
authors.forename: M
authors.initials: M
authors.lastname: Impallomeni
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D016360:Clostridioides difficile; D003967:Diarrhea / Q000453:epidemiology* / Q000276:immunology / Q000382:microbiology / Q000517:prevention & control; D004196:Disease Outbreaks; D004761:Enterocolitis, Pseudomembranous / Q000453:epidemiology* / Q000276:immunology / Q000517:prevention & control; D006801:Humans; D007109:Immunity; D017053:Infection Control / Q000379:methods; D008962:Models, Theoretical; D011153:Population
chemical_list: D000900:Anti-Bacterial Agents