Category Archives: Clostridioides difficile Infection

Study Finds C.diff. Infections Could Be Reduced by 13% In Hospital Transfers

“We defined a patient transfer as a patient discharged from one hospital and then admitted to another hospital on the same day.”

The study findings reinforce that infection prevention and control strategies should be conducted at the regional level to better minimize the spread of HAIs, Sewell and colleagues said.

Study findings showed that hospital transfers cause a “minority but substantial burden” of Clostridioides difficile infections in California and that the burden could be reduced by 13% statewide if contamination from hospital transfers was eliminated.

Hospital transfers are known to be associated with the spread of pathogens like C. difficile and MRSA, but researchers said it is critical to better understand the role that hospital transfers play in the spread of hospital-acquired infections, or HAIs.

“The relationship between hospital transfers and higher levels of HAIs is unclear, as is the public health significance of this relationship,” Daniel K. Sewell, PhD, assistant professor of biostatistics in the University of Iowa College of Public Health, and colleagues wrote.

They conducted a retrospective observational study using data collected between 2005 and 2011 from the Healthcare Cost and Utilization Project California State Inpatient Database.

“We were able to discern transfers between hospitals by considering patients who had common discharge and admission dates involving two distinct hospitals,” Sewell and colleagues wrote. “We defined a patient transfer as a patient discharged from one hospital and then admitted to another hospital on the same day.”

According to the study, Sewell and colleagues identified 26,878,498 admissions and 532,925 patient transfers across 385 hospitals. They found that 13% of C. difficile infections (CDIs) were a result of patient transfers (95% CI, 7.6%-18%). Additionally, the researchers observed CDI cases increase at receiving hospitals when the number of transfer patients increased or when the CDI rate at the transferring hospital increased, or both.

“Transfers of patients demonstrate the interconnectedness of health care systems,” they wrote. “Accordingly, efforts to control the spread of infections at one facility may benefit others, and the less rigorous infection control efforts at some hospitals may impact the infection rates at other hospitals within a transfer network.” – by Marley Ghizzone

 

 

 

 

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https://www.healio.com/infectious-disease/nosocomial-infections/news/online/%7B7bc8ae6c-fcc3-4ca6-a625-29301eb6535a%7D/eliminating-contamination-from-hospital-transfers-could-reduce-cdi-cases-by-13

First Time Clostridioides difficile Infection Study Reveals Correlation Between Antibiotic Use and CDI Utilizing Data From 2006-2012

ABSTRACT :   Association between Antibiotic Use and Hospital-Onset Clostridioides difficile Infection in U.S. Acute Care Hospitals, 2006-2012: an Ecologic Analysis

“> Sophia V Kazakova, M.D., M.P.H, Ph.D James Baggs, Ph.D L Clifford McDonald, M.D Sarah H Yi, Ph.D Kelly M Hatfield, M.S.P.H Alice Guh, M.D., M.P.H Sujan C Reddy, M.D., M.Sc John A Jernigan, M.D., M.S

Clinical Infectious Diseases, ciz169, https://doi.org/10.1093/cid/ciz169
Published:
01 March 2019
Article history

Abstract

Background

Unnecessary antibiotic use (AU) contributes to increased rates of Clostridioides difficile Infection (CDI). The impact of antibiotic restriction on hospital-onset CDI (HO-CDI) has not been assessed in a large group of U.S. acute care hospitals (ACHs).

Methods

We examined cross-sectional and temporal associations between rates of hospital-level AU and HO-CDI using data from 549 ACHs. HO-CDI, a discharge with a secondary ICD-9-CM for CDI (008.45) and treatment with metronidazole or oral vancomycin ≥ 3 days after admission. Analyses were performed using multivariable generalized estimating equation models adjusting for patient and hospital characteristics.

Results

During 2006-2012, the unadjusted annual rates of HO-CDI and total AU were 7.3 per 10,000 patient-days (PD) (95% CI: 7.1-7.5) and 811 days of therapy (DOT)/1,000 PD (95% CI: 803-820), respectively. In the cross-sectional analysis, for every 50 DOT/1,000 PD increase in total AU, there was a 4.4% increase in HO-CDI.

For every 10 DOT/1,000 PD increase in use of third- and fourth-generation cephalosporins or carbapenems there was a 2.1% and 2.9% increase in HO-CDI, respectively. In the time-series analysis, the 6 ACHs with a ≥ 30% decrease in total AU had a 33% decrease in HO-CDI (rate ratio, 0.67; 95% CI, 0.47-0.96); ACHs with a ≥ 20% decrease in fluoroquinolone or third- and fourth-generation cephalosporin use had a corresponding decrease in HO-CDI of 8% and 13%, respectively.

Conclusions

At an ecologic level, reductions in total AU, use of fluoroquinolones and third- and fourth-generation cephalosporins were each associated with decreased HO-CDI rates.

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https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciz169/5367464?fbclid=IwAR0S6XfRWoKTJNmBoZLQicy2BqzuOOyRF9dx2ctQGRn0K9K0m79cr7Or7pQ