25-Hydroxyvitamin D Concentrations and Clostridium difficile Infection: A Meta-Analysis

Luis Furuya-Kanamori, Kinley Wangdi, Laith Yakob, Samantha J. McKenzie, Suhail A R Doi, Justin Clark, David L. Paterson, Thomas V. Riley, Archie C A Clements

    Research output: Contribution to journalArticle

    Abstract

    Background: Well-known risk factors for Clostridium difficile infection (CDI) are exposure to antibiotics and gastric acid suppressants. Recent studies have provided some evidence of an association between hypovitaminosis D and the risk of CDI. Therefore, this meta-analysis aimed to pool all the existing evidence to investigate the association between 25-hydroxyvitamin D (25[OH]D) and CDI. Methods: A systematic search was conducted in 3 databases (PubMed, Embase, and Web of Sciences) for epidemiological studies that examined the association between mean 25(OH)D concentrations and CDI as well as between 25(OH)D status and CDI severity or recurrence. 25(OH)D status was defined as "lower" or "higher" at a threshold concentration of <20 or ≥20 ng/mL, respectively. Pooled effect sizes were computed using the inverse variance heterogeneity model of meta-analysis. Results: Eight publications (n = 4479 patients) were included in the meta-analysis. The mean concentration of 25(OH)D in patients with CDI was 3.54 ng/mL (95% confidence interval [CI], 0.39-6.89 ng/mL) lower than in patients without CDI. Patients with lower 25(OH)D status had a higher odds (odds ratio [OR], 1.61; 95% CI, 1.02-2.53) of developing severe CDI compared with those with a higher 25(OH)D status. No significant association was found between 25(OH)D status and CDI recurrence. Conclusion: The results of this meta-analysis suggest that lower mean concentrations of 25(OH)D were associated with CDI. A lower 25(OH)D status increased the odds of severe CDI but not of CDI recurrence.

    Original languageEnglish
    Pages (from-to)890-895
    Number of pages6
    JournalJournal of Parenteral and Enteral Nutrition
    Volume41
    Issue number5
    DOIs
    Publication statusPublished - 1 Jul 2017

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    Clostridium Infections
    Clostridium
    Clostridium difficile
    Meta-Analysis
    Recurrence
    25-hydroxyvitamin D
    Confidence Intervals
    Gastric Acid
    Antibiotics
    PubMed
    Publications
    Epidemiologic Studies

    Cite this

    Furuya-Kanamori, L., Wangdi, K., Yakob, L., McKenzie, S. J., Doi, S. A. R., Clark, J., ... Clements, A. C. A. (2017). 25-Hydroxyvitamin D Concentrations and Clostridium difficile Infection: A Meta-Analysis. Journal of Parenteral and Enteral Nutrition, 41(5), 890-895. https://doi.org/10.1177/0148607115623457
    Furuya-Kanamori, Luis ; Wangdi, Kinley ; Yakob, Laith ; McKenzie, Samantha J. ; Doi, Suhail A R ; Clark, Justin ; Paterson, David L. ; Riley, Thomas V. ; Clements, Archie C A. / 25-Hydroxyvitamin D Concentrations and Clostridium difficile Infection : A Meta-Analysis. In: Journal of Parenteral and Enteral Nutrition. 2017 ; Vol. 41, No. 5. pp. 890-895.
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    Furuya-Kanamori, L, Wangdi, K, Yakob, L, McKenzie, SJ, Doi, SAR, Clark, J, Paterson, DL, Riley, TV & Clements, ACA 2017, '25-Hydroxyvitamin D Concentrations and Clostridium difficile Infection: A Meta-Analysis' Journal of Parenteral and Enteral Nutrition, vol. 41, no. 5, pp. 890-895. https://doi.org/10.1177/0148607115623457

    25-Hydroxyvitamin D Concentrations and Clostridium difficile Infection : A Meta-Analysis. / Furuya-Kanamori, Luis; Wangdi, Kinley; Yakob, Laith; McKenzie, Samantha J.; Doi, Suhail A R; Clark, Justin; Paterson, David L.; Riley, Thomas V.; Clements, Archie C A.

    In: Journal of Parenteral and Enteral Nutrition, Vol. 41, No. 5, 01.07.2017, p. 890-895.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - 25-Hydroxyvitamin D Concentrations and Clostridium difficile Infection

    T2 - A Meta-Analysis

    AU - Furuya-Kanamori, Luis

    AU - Wangdi, Kinley

    AU - Yakob, Laith

    AU - McKenzie, Samantha J.

    AU - Doi, Suhail A R

    AU - Clark, Justin

    AU - Paterson, David L.

    AU - Riley, Thomas V.

    AU - Clements, Archie C A

    PY - 2017/7/1

    Y1 - 2017/7/1

    N2 - Background: Well-known risk factors for Clostridium difficile infection (CDI) are exposure to antibiotics and gastric acid suppressants. Recent studies have provided some evidence of an association between hypovitaminosis D and the risk of CDI. Therefore, this meta-analysis aimed to pool all the existing evidence to investigate the association between 25-hydroxyvitamin D (25[OH]D) and CDI. Methods: A systematic search was conducted in 3 databases (PubMed, Embase, and Web of Sciences) for epidemiological studies that examined the association between mean 25(OH)D concentrations and CDI as well as between 25(OH)D status and CDI severity or recurrence. 25(OH)D status was defined as "lower" or "higher" at a threshold concentration of <20 or ≥20 ng/mL, respectively. Pooled effect sizes were computed using the inverse variance heterogeneity model of meta-analysis. Results: Eight publications (n = 4479 patients) were included in the meta-analysis. The mean concentration of 25(OH)D in patients with CDI was 3.54 ng/mL (95% confidence interval [CI], 0.39-6.89 ng/mL) lower than in patients without CDI. Patients with lower 25(OH)D status had a higher odds (odds ratio [OR], 1.61; 95% CI, 1.02-2.53) of developing severe CDI compared with those with a higher 25(OH)D status. No significant association was found between 25(OH)D status and CDI recurrence. Conclusion: The results of this meta-analysis suggest that lower mean concentrations of 25(OH)D were associated with CDI. A lower 25(OH)D status increased the odds of severe CDI but not of CDI recurrence.

    AB - Background: Well-known risk factors for Clostridium difficile infection (CDI) are exposure to antibiotics and gastric acid suppressants. Recent studies have provided some evidence of an association between hypovitaminosis D and the risk of CDI. Therefore, this meta-analysis aimed to pool all the existing evidence to investigate the association between 25-hydroxyvitamin D (25[OH]D) and CDI. Methods: A systematic search was conducted in 3 databases (PubMed, Embase, and Web of Sciences) for epidemiological studies that examined the association between mean 25(OH)D concentrations and CDI as well as between 25(OH)D status and CDI severity or recurrence. 25(OH)D status was defined as "lower" or "higher" at a threshold concentration of <20 or ≥20 ng/mL, respectively. Pooled effect sizes were computed using the inverse variance heterogeneity model of meta-analysis. Results: Eight publications (n = 4479 patients) were included in the meta-analysis. The mean concentration of 25(OH)D in patients with CDI was 3.54 ng/mL (95% confidence interval [CI], 0.39-6.89 ng/mL) lower than in patients without CDI. Patients with lower 25(OH)D status had a higher odds (odds ratio [OR], 1.61; 95% CI, 1.02-2.53) of developing severe CDI compared with those with a higher 25(OH)D status. No significant association was found between 25(OH)D status and CDI recurrence. Conclusion: The results of this meta-analysis suggest that lower mean concentrations of 25(OH)D were associated with CDI. A lower 25(OH)D status increased the odds of severe CDI but not of CDI recurrence.

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    KW - Clostridium difficile

    KW - infection

    KW - recurrence

    KW - severity

    KW - Vitamin D

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