Table 4 Cumulative incidence of AAD within 28 and 90 days.

From: Incidence and predictive biomarkers of Clostridioides difficile infection in hospitalized patients receiving broad-spectrum antibiotics

Subgroup

N

Events

Incidence

SDHR

AAD within 28 days

Total population

1007

101.7

10.5% (8.7–12.6)

 

Penicillin + BLI

409

45.5

11.6% (8.6–15.0)

1.2 (0.8-1.8)

Third/fourth gen cephalosporin

394

29.6

7.8% (5.3–10.8)

0.6 (0.4–1.0)

Fluoroquinolone

181

18.6

10.7% (6.6–15.9)

1.0 (0.6–1.7)

Carbapenem

64

15.6

25.0% (14.9–36.4)

2.8 (1.7–4.9)

Clindamycin

29

2.0

7.6% (1.3–21.8)

0.7 (0.2–2.6)

History of CDI

31

3.8

13.0% (2.5–32.1)

1.2 (0.3–4.6)

No history of CDI

976

97.9

10.4% (8.5–12.5)

–

Toxigenic C. difficile carriage (GeneXpert, Cepheid)

45

7.8

18.1% (7.9–31.4)

1.9 (0.9-4.0)

No toxigenic C. difficile carriage

962

93.9

10.2% (8.3–12.2)

–

Intermediate N3-IS level (−8 ≤ log2(N3-IS) ≤ 2.5)

38

2.8

7.5% (1.5–20.1)

0.7 (0.2-2.7)

High N3-IS level (log2(N3-IS) > 2.5)

969

98.9

10.6% (8.7–12.7)

–

Shannon index ≤ 3.155

399

49.4

12.8% (9.6–16.5)

1.5 (1.0-2.2)

Shannon index > 3.155

608

52.4

9.0% (6.8–11.5)

–

Inverse Simpson index ≤ 14.339

529

59.2

11.6% (8.9–14.6)

1.3 (0.8-1.9)

Inverse Simpson index > 14.339

478

42.5

9.3% (6.8–12.2)

–

AAD within 90 days

Total population

1007

135.0

14.1% (12.0–16.4)

 

Penicillin + BLI

409

51.0

13.1% (9.9–16.6)

0.9 (0.6–1.3)

Third/fourth gen cephalosporin

394

47.0

12.6% (9.4–16.1)

0.8 (0.6–1.1)

Fluoroquinolone

181

25.0

14.6% (9.8–20.3)

1.0 (0.7–1.6)

Carbapenem

64

21.0

33.8% (22.3–45.7)

3.0 (1.9–4.7)

Clindamycin

29

3.0

11.4% (2.8–26.8)

0.8 (0.2–2.3)

History of CDI

31

3.9

13.4% (2.6–33.0)

0.9 (0.2–3.6)

No history of CDI

976

131.1

14.1% (11.9–16.5)

–

Toxigenic C. difficile carriage (GeneXpert, Cepheid)

45

8.3

19% (8.6–32.5)

1.5 (0.7–3.1)

No toxigenic C. difficile carriage

962

126.7

13.9% (11.7–16.2)

–

Intermediate N3-IS level (−8 ≤ log2(N3-IS) ≤ 2.5)

38

4.1

11.0% (3.0–24.7)

0.8 (0.2–2.3)

High N3-IS level (log2(N3-IS) > 2.5)

969

130.9

14.2% (12.0–16.6)

–

Shannon index ≤ 3.155

399

67.2

17.7% (13.9–21.8)

1.5 (1.1–2.2)

Shannon index > 3.155

608

67.8

11.7% (9.2–14.5)

–

Inverse Simpson index ≤ 14.339

529

80.1

15.9% (12.8–19.3)

1.3 (0.9–1.9)

Inverse Simpson index > 14.339

478

54.9

12.1% (9.3–15.4)

–

Ratio OTU21/OTU648 ≥ 6§

227

51.0

20.0% (14.7–25.8)

1.7 (1.3–2.4)

Ratio OTU21/OTU648 < 6

780

84.0

12.3% (9.9–15.2)

–

At least two of OTU69 < 0.140% or OTU21 ≥ 0.013% or OTU648 < 0.006%a

448

87.2

18.4% (14.4–22.8)

1.8 (1.4–2.4)

Less than two of OTU69 < 0.140% or OTU21 ≥ 0.013% or OTU648 < 0.006%

559

47.8

10.6% (8.2–13.4)

–

  1. Based on the competing events model using multiple imputed data. The number of events is averaged over the imputation datasets and can therefore have decimals. Cumulative incidence was calculated using competing events analysis. Abbreviations: AAD antibiotic associated diarrhea, BLI beta-lactamase inhibitor, CDI Clostridioides difficile infection, CI confidence interval, N3-IS normalized 3-indoxyl sulfate level in urine, OTU21 uncultured Lachnospiraceae, OTU69 Porphyromonas, OTU648 Blautia, SDHR subdistribution hazard ratio. Bold text denotes statistical significance. §,†Bias-adjusted incidences and SDHR are provided. §The bias-adjusted sensitivity, specificity and C-statistic were 32.1%, 79.0%, and 0.555, respectively.
  2. aThe bias-adjusted sensitivity, specificity and C-statistic were 58.2%, 57.8% and 0.580, respectively.
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