UCL Discovery
UCL home » Library Services » Electronic resources » UCL Discovery

Clostridium difficile infection and risk of Parkinson's disease: a Swedish population‐based cohort study

Kang, X; Ploner, A; Ludvigsson, JF; Williams, DM; Larsson, H; Pedersen, NL; Wirdefeldt, K; (2020) Clostridium difficile infection and risk of Parkinson's disease: a Swedish population‐based cohort study. European Journal of Neurology 10.1111/ene.14400. (In press). Green open access

[thumbnail of ene.14400.pdf]
Preview
Text
ene.14400.pdf - Published Version

Download (996kB) | Preview

Abstract

Background and purpose: Gastrointestinal inflammation has been implicated in Parkinson’s disease (PD). The aim of this study was to examine whether individuals with a history of Clostridium difficile infection (CDI) are at elevated risk of PD. Methods: We performed a population-based cohort study using Swedish national register data. Adults aged ≥35 years were identified from the Swedish Population and Housing Census 1990 and followed during the period 1997– 2013. Diagnoses of CDI and PD were extracted from the National Patient Register. Associations of CDI history with PD risk were estimated using Cox proportional hazards regression. We also explored whether the association differed by the source of CDI diagnosis (inpatient vs. outpatient), presence of recurrent infections, and pre-infection use of antibiotics. Results: Amongst the study population (N = 4 670 423), 34 868 (0.75%) had a history of CDI. A total of 165 and 47 035 incident PD cases were identified from individuals with and without CDI history, respectively. Across the entire follow-up, a 16% elevation of PD risk was observed among the CDI group [hazard ratio 1.16, 95% confidence interval (CI)1.00–1.36], which was mainly driven by increased PD risk within the first 2 years after CDI diagnosis (hazard ratio 1.38, 95% CI 1.12–1.69). In longer follow-up, CDI was not associated with subsequent PD occurrence. This temporal pattern of CDI–PD associations was generally observed across all CDI subgroups. Conclusions: Clostridium difficile may be associated with an increased shortterm PD risk, but this might be explained by reverse causation and/or surveillance bias. Our results do not imply that CDI history affects long-term PD risk.

Type: Article
Title: Clostridium difficile infection and risk of Parkinson's disease: a Swedish population‐based cohort study
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/ene.14400
Publisher version: https://doi.org/10.1111/ene.14400
Language: English
Additional information: This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. http://creativecommons.org/licenses/by-nc-nd/4.0/
Keywords: Clostridium difficile infection, cohort study, Parkinson’s disease
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Population Science and Experimental Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Population Science and Experimental Medicine > MRC Unit for Lifelong Hlth and Ageing
URI: https://discovery.ucl.ac.uk/id/eprint/10110490
Downloads since deposit
56Downloads
Download activity - last month
Download activity - last 12 months
Downloads by country - last 12 months

Archive Staff Only

View Item View Item