Tag Archives: Healio Gastroenterology and Liver Disease.

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

Hand-Washing aka Hand Hygiene Patient Education Proves Successful To Reduce C.diff. Infections

HandHygiene #1 Prevention

Hand-Washing aka hand hygiene Remains #1 In Infection Prevention In Every Setting.

“Despite evidence to suggest that [hand hygiene] is important in preventing infection, hospitalized patients are often not provided the opportunity to clean their hands,” due to mobility and cognitive obstacles as well as lack of education, investigators wrote.

Education on patient hand hygiene significantly reduced the incidence of Clostridium difficile infection at University of Pittsburgh Medical Center Mercy Hospital.

First, they conducted baseline surveys to assess patient hand hygiene, which showed patients needed more opportunities to wash their hands. Then nurse educators provided staff with an educational presentation on the importance of patient hand hygiene for preventing infection, which included specific times they should encourage and assist patients with hand hygiene. Staff then provided education and assistance to newly admitted patients, and researchers conducted additional surveys after implementation of this intervention.

During the first phase of the study involving just four medical-surgical nursing units, patient hand hygiene education increased significantly after the intervention (P < .0001). Overall, 97 follow-up surveys showed the proportion of those who received hand hygiene education increased from 34% to 64%, the opportunities provided for hand hygiene increased from 60% to 86%, and the average number of times hand hygiene was performed daily increased from 2.7 to 3.75.

After expanding the intervention to the whole hospital in the second phase of the study, 189 follow-up surveys showed that patient hand hygiene education increased from 48% to 53%. Meanwhile, overall opportunities for hand hygiene remained unchanged from 68%, and daily frequency of patient hand hygiene did not change significantly (mean, 2.4 vs. 2.6 times per day).

Notably, CDI rates dropped significantly during the 6 months following hospital-wide implementation.

“[Standardized infection ratio] P values for Q2 and W3 (0.0157 and 0.0103, respectively) were significantly lower than expected (P .05),” investigators wrote. “The Q4 SIR, however, showed an increase to 0.3844 over the 2 preceding quarters.”

They concluded that these findings showed patient hand hygiene “should be considered a potential addition to CDI prevention measures in hospitalized patients.” – by Adam Leitenberger

Source:  https://www.healio.com/gastroenterology/infection/news/online/%7B0ea95c50-ddec-4259-a229-5979fde9d8af%7D/patient-handwashing-cuts-c-difficile-rate-in-hospital

Surotomycin Failed To Show Benefit Over Vancomycin In a Pivotal Phase 3 Trial To Treat C. difficile Infections

A similar proportion of patients with Clostridium difficile infection showed clinical response at the end of treatment with surotomycin vs. vancomycin in a pivotal phase 3 trial.

However, surotomycin did not demonstrate superiority for key secondary endpoints including sustained clinical response and clinical response over time, and therefore failed to show benefit over vancomycin.

 

As published :  https://www.healio.com/gastroenterology/infection/news/online/%7B3531418d-42aa-4092-a9f2-55ba2ce6dcda%7D/surotomycin-meets-non-inferiority-endpoint-fails-to-show-benefit-over-vancomycin-in-c-difficile

This follows previously reported results of a parallel phase 3 trial in which surotomycin failed to meet non-inferiority criteria relative to vancomycin for primary and key secondary endpoints.

“Surotomycin has a narrow spectrum of activity, demonstrating low resistance rates and rapid activity against C. difficile with similar dose- and time-dependent pharmacodynamics to vancomycin in resolving CDI in a hamster model,” Sahil Khanna, MBBS, of the division of gastroenterology and hepatology at the Mayo Clinic in Rochester, Minn., told Healio Gastroenterology and Liver Disease.

In this second phase 3 trial, “surotomycin demonstrated non-inferiority to vancomycin for CDI clinical response at end of treatment. It was similar to vancomycin for sustained clinical cure.”

In this double-blind, international multicenter trial, Khanna and colleagues randomly assigned 285 patients with confirmed CDI to receive 250 mg oral surotomycin twice daily alternating with placebo twice daily, and 292 to receive 125 mg oral vancomycin four times daily for 10 days.

At the end of treatment, clinical response with surotomycin (83.4%) was non-inferior to vancomycin (82.1%), with a difference of 1.4% (95% CI, 4.9-7.6).

Through 30 to 40 days of follow-up, clinical response over time was not superior to surotomycin, nor was sustained clinical response (63.3% vs. 59%; difference, 4.3%; 95% CI, 3.6-12.2).

Both treatments were generally well tolerated, with typical treatment-emergent adverse events occurring in 52.4% of patients treated with surotomycin and 60.1% of those treated with vancomycin.

“Interestingly, in the hypervirulent strain of CDI, recurrence rate was lower for surotomycin vs. vancomycin,” Khanna said, though he and colleagues noted in the study manuscript that “this finding is nominal due to a lack of multiplicity control.”

Based on the results of these trials, the surotomycin development program has been discontinued, but “the non-inferiority of surotomycin to vancomycin observed in the current trial is in contrast with the parallel trial,” investigators wrote. – by Adam Leitenberger

Disclosures: This study was funded by Merck. Khanna reports he has served as an advisor to Summit Pharmaceuticals and serves as a consultant to Rebiotix and Assembly Biosciences. Please see the full study for a list of all other researchers’ relevant financial disclosures.

SOURECE:  https://www.healio.com/gastroenterology/infection/news/online/%7B3531418d-42aa-4092-a9f2-55ba2ce6dcda%7D/surotomycin-meets-non-inferiority-endpoint-fails-to-show-benefit-over-vancomycin-in-c-difficile