Tag Archives: C Diff Foundation Infection Prevention

Researchers Evaluate Healthcare-Onset and Healthcare-Facility-Associated C. difficile Infections

 

Authors:
Dipesh Solanky12Derek K Juang#12Scott T Johns#3Ian C Drobish12Sanjay R Mehta124Monika Kumaraswamy1245

Abstract

Objective: Lack of judicious testing can result in the incorrect diagnosis of Clostridioides difficile infection (CDI), unnecessary CDI treatment, increased costs, and falsely augmented hospital-acquired infection (HAI) rates. We evaluated facility-wide interventions used at the VA San Diego Healthcare System (VASDHS) to reduce healthcare-onset, healthcare-facility-associated CDI (HO-HCFA CDI), including the use of diagnostic stewardship with test ordering criteria.

Design: We conducted a retrospective study to assess the effectiveness of measures implemented to reduce the rate of HO-HCFA CDI at the VASDHS from fiscal year (FY)2015 to FY2018.

Interventions: Measures executed in a stepwise fashion included a hand hygiene initiative, prompt isolation of CDI patients, enhanced terminal room cleaning, reduction of fluoroquinolone and proton-pump inhibitor use, laboratory rejection of solid stool samples, and lastly diagnostic stewardship with C. difficile toxin B gene nucleic acid amplification testing (NAAT) criteria instituted in FY2018.

Results: From FY2015 to FY2018, 127 cases of HO-HCFA CDI were identified. All rate-reducing initiatives resulted in decreased HO-HCFA cases (from 44 to 13; P ≤ .05). However, the number of HO-HCFA cases (34 to 13; P ≤ .05), potential false-positive testing associated with colonization and laxative use (from 11 to 4), hospital days (from 596 to 332), CDI-related hospitalization costs (from $2,780,681 to $1,534,190) and treatment cost (from $7,158 vs $1,476) decreased substantially following the introduction of diagnostic stewardship with test criteria from FY2017 to FY2018.

Conclusions: Initiatives to decrease the risk for CDI and diagnostic stewardship of C. difficile stool NAAT significantly reduced HO-HCFA CDI rates, detection of potential false-positives associated with laxative use, and lowered healthcare costs. Diagnostic stewardship itself had the most dramatic impact on outcomes observed and served as an effective tool in reducing HO-HCFA CDI rates.

 

 

 

 

To view the article in its entirety please click on the link below to be redirected. Thank You.

https://pubmed.ncbi.nlm.nih.gov/32943129/

C Diff Foundation Welcomes Glenn Tillitson, PhD, FIDSA, FRSM, FCCP, FISC Co-Chair, Infection Prevention and Control Committee

We are pleased to welcome Dr. Glenn Tillitson,  PhD, FIDSA, FRSM, FCCP, FISC as a Member of the C Diff Foundation, Co.-Chair of the Infection Prevention and Control Committee, (Non-Executive Director).

Glenn has over 30 years in experience in global infectious disease and with a focus in anti-infective drug development and medical educational and medical affairs. Glenn has written many publications in the various aspects of ID (>150 papers on PubMed with a further >40 not cited). Demonstrated capabilities in broad-ranging educational initiatives aimed at improving patient health. Glenn has published multiple publications and an e-book on C difficile.  Recently he has been active in developing new products for Clostridium difficile, MRSA and MDR Gram-negative infections. Built and led a medical affairs team to prepare for the approval and launch of a fourth-generation macrolide for use in pneumonia. Most recently played a role in the approval of cefiderocol ,a novel siderophore cephalosporin, in the US.

We look forward to Dr. Tillitson collaborating with members of the Infection Prevention and Control Committee to develop continued strategy for Infection Prevention & Control and to join the decision making IPC committee members to ensure that the Infection Prevention & Control Annual Conference Program material is agreed, developed and implemented for the good of fellow-healthcare professionals worldwide.  

C diff Infection Control and Hospital Epidemiology Initiative Helps Reduce CDI Rates in VA Facilities

A significant decrease in rates of clinically confirmed long-term care facility onset Clostridium difficile infection (CDI) at 132 Veteran’s Affairs facilities coincided with implementation of a nationwide prevention initiative, researchers report in a new study in Infection Control and Hospital Epidemiology.

The initiative for prevention of CDI in VA long-term care facilities (LTCFs) was implemented in February 2014 following implementation in VA acute care facilities in July 2012. The initiative, which emphasizes environmental management, hand hygiene, contact precautions, and institutional culture change, was extended and tailored to VA LTCFs because they are often linked to VA acute care facilities, where CDI has become the most common healthcare-associated infection. To evaluate the impact of the initiative, the researchers analyzed quarterly CDI trends from the first 33 months of the program and compared them with the 2 years prior to implementation.

The analysis found that there were 137,289 admissions, 9,288,098 resident days, and 1,373 clinically confirmed LTCF-onset CDI cases from April 2014 through December 2016.

The nationwide number of clinically confirmed LTCF-onset CDI cases did not change in the 2 years prior to implementation of the prevention initiative but decreased by 36.1% over the 33-month analysis period.

The results mirror the experience in VA acute care facilities, which saw a 15% drop in hospital-acquired CDI cases over the first 33 months of the prevention initiative, and the authors note that this may have had an impact on their findings, along with strong leadership from the VA Central Office and individual facility accountability.

“The exact reason for the decrease in cases within the VA LTCFs is not known,” they write. “Given the large number of facilities involved and the long observation period, we were not able to collect data on individual facility activities or sustainability of activities; hence, we cannot report a ‘magic bullet’ responsible for the declining trend.”

Study shows substantial burden of primary, recurrent C diff

In another study on CDI, researchers with Merck’s Center for Observational and Real World Evidence estimated the healthcare resource utilization (HCRU) and costs attributable to primary CDI and recurrent CDI (rCDI).

In the retrospective observational study, published in Clinical Infectious Diseases, the researchers analyzed administrative claims data from two commercial databases representing nearly 50 million individuals with private health insurance.

To obtain hospitalized days and costs attributable to primary CDI, patients without CDI were matched 1:1 by propensity score to those with primary CDI but no recurrences. To obtain hospitalized days and costs associated with rCDI, patients with primary CDI but no recurrences were matched 1:1 to those with primary CDI plus one recurrence.

A total of 55,504 CDI patients were identified from July 2010 through June 2014, and among those patients 24.8% had a recurrence. Compared to those patients without CDI, the cumulative hospitalized days and healthcare costs attributable to primary CDI were 5.20 days and $24,205. Compared to those patients with primary CDI only, the cumulative hospitalized days and healthcare costs attributable to rCDI were 1.95 days and $10,580.

“In conclusion, the HCRU and economic burden associated with primary and rCDI are quite substantial,” the authors write. “Better prevention and treatment of CDI, especially rCDI, are needed.”

To read article in its entirety please click on the following link:  http://www.cidrap.umn.edu/news-perspective/2018/01/stewardship-resistance-scan-jan-22-2018

 

C Diff Foundation Global Network Welcomes Ron Romano, RN

We are pleased to welcome Ron Romano, RN to the C Diff Foundation Global Network.

Ron Romano, RN  presides as Infection Prevention Advocate.

 

Ron has certifications from the following organizations :

      • American Association for LTC Nursing – Co-founder Past President – 2007- 2015
      • American Association for Safe Patient Handling – Board Member 2010-2012
      • Association for Professionals in Infection Control & Epidemiology – Current Member
      • Safety Specialist LTC – Certification – Current

C. difficile Infections are no stranger to Ron as his family members have also been touched by this infection.  His background in healthcare and passion for Infection Prevention and Epidemiology is an asset to many.  Ron is the Owner, President and CEO of Safety Net LLC in Cincinnati, Ohio.

Safety Net is a national healthcare safety consulting and distribution company providing unique product solutions to mitigate risk associated to infections. We serve acute care hospitals, post-acute and home-care. Our solutions protect our healthcare workers and those under their care.

Ron has also been the Past-President in the following organizations:

American Association for LTC Nursing (AALTCN) 07-15    The AALTCN is a professional organization that supports all levels of caregivers providing career ladder with supporting education, certifications and resources. AALTCN has recently merged with the American Association for Nurse Assessment Coordinators to form the largest professional nursing organization in long term care.

Health Education Network – 07-15,  Co-owner – President

Health Education Network is a medical publication company that provides Nursing education for all levels of caregivers on a variety of topics for LTC. Certificate programs are available for Staff Development Coordinators, Nurse Assessment Coordinators, Director of Nursing in LTC, RN and LPN in LTC.

National Association Director of Nursing Administration (NADONA/LTC) Cincinnati, Ohio 01-07

NADONA/LTC is a professional organization representing Directors of Nursing, Assistant Directors of Nursing and Clinical Managers in long-term care. NADONA/LTC has 38 state chapters nationally and internationally in Canada.

We welcome Ron to the C Diff Foundation and appreciate his healthcare background to join us in promoting Infection prevention and C. diff. Awareness worldwide with fellow members