title: Risk factors for development of Clostridium difficile infection due to BI/NAP1/027 strain: a meta-analysis.
abstract: OBJECTIVE
  To identify risk factors for the development of Clostridium difficile infection (CDI) due to C. difficile BI/NAP1/027 strain.
  
  
  METHODS
  PubMed and Scopus databases were searched for studies that sought to identify risk factors for CDI due to the BI/NAP1/027 strain. The technique of meta-analysis was applied.
  
  
  RESULTS
  Five studies compared CDI BI/NAP1/027 patients to CDI patients infected with non-BI/NAP1/027 strains, one compared CDI BI/NAP1/027 patients to non-CDI patients, and one provided data for both comparisons. The meta-analysis showed that fluoroquinolones were associated with a higher risk of CDI due to BI/NAP1/027 when compared to non-BI/NAP1/027 CDI (odds ratio (OR) 1.96, 95% confidence interval (95% CI) 1.37-2.80). A trend towards a lower risk for CDI due to BI/NAP1/027 was observed with cephalosporins when compared to non-BI/NAP1/027 CDI (OR 0.70, 95% CI 0.46-1.07). Prior macrolides were not associated with a higher risk for CDI BI/NAP1/027 when compared with non-BI/NAP1/027 CDI controls (OR 0.88, 95% CI 0.44-1.78). Clindamycin administration was associated with a lower risk for CDI due to BI/NAP1/027 when compared to non-BI/NAP1/027 CDI (OR 0.24, 95% CI 0.12-0.48). Age over 65 years was associated with an increased risk of CDI BI/NAP1/027 compared to non-BI/NAP1/027 CDI (OR 1.77, 95% CI 1.31-2.38).
  
  
  CONCLUSIONS
  Fluoroquinolones and age over 65 years were associated with a higher risk of CDI due to the BI/NAP1/027 strain. Clindamycin was associated with a lower risk of CDI due to BI/NAP1/027.
authors.affiliation: Alfa Institute of Biomedical Sciences, Marousi, Athens, Greece.
authors.forename: Konstantinos Z
authors.initials: KZ
authors.lastname: Vardakas
authors.forename: Athanasios A
authors.initials: AA
authors.lastname: Konstantelias
authors.forename: Giorgos
authors.initials: G
authors.lastname: Loizidis
authors.forename: Petros I
authors.initials: PI
authors.lastname: Rafailidis
authors.forename: Matthew E
authors.initials: ME
authors.lastname: Falagas
mesh_terms: D000367:Age Factors; D000368:Aged; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use; D016360:Clostridioides difficile / Q000145:classification*; D004761:Enterocolitis, Pseudomembranous / Q000188:drug therapy / Q000382:microbiology*; D024841:Fluoroquinolones / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D012307:Risk Factors
chemical_list: D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones