Global Patterns of <i>Clostridioides difficile</i> Infection in Patients with Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis of Prevalence, Epidemiology, and Risk Factors
Bibliographic record
Abstract
Background: infection (CDI) is a well-recognized complication of inflammatory bowel disease (IBD) that has been associated with poor clinical outcomes. The objective of this study is to characterize the global incidence, risk factors and outcomes of CDI in patients with IBD. Methods: A search of MEDLINE/PubMed, Scopus, and Cochrane Database of Systematic Reviews was conducted for studies published between January 1960, and March 2024. Random-effect models were employed to estimate the incidence of CDI in the IBD population. Risk factors and outcomes were estimated using random effects meta-regression and subgroup analysis. Results: Twenty-eight articles from 11 countries on 3 continents, comprising 796, 244 patients with IBD were included. The overall CDI rate was 8.84% (95% CI, 5.91%-13.03%). The rate of CDI was slightly higher in Asia at 11% (95% CI, 6.7%-18.44%) compared to the North America (USA and Canada) at 7.85% (95% CI, 3.80%-15.51%) and Europe, where the incidence, was 7.92% (95% CI, 3.87%-15.51%). A univariable random-effects meta-regression model demonstrated that male gender (odds ratio [OR], 1.18; 95% CI, 1.00-1.40) and older age (OR, 1.06; 95% CI, 0.99-1.15, per one-year increase in age) were factors associated with higher CDI incidence in the IBD population. CDI testing by PCR compared to enzyme immunoassay was associated with higher rates of CDI (OR, 4.70; 95% CI, 01.39-15.90). No association was observed between length of hospital stay and CDI. Conclusions: One in 10 patients with IBD were positive for CDI. Increasing age and male population were associated with higher risk of CDI.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.015 | 0.028 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.019 | 0.040 |
| Bibliometrics | 0.009 | 0.010 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".