Abstract:
OBJECTIVE:To compare the occurrence of Clostridium difficile among inpatients infected with human immunodeficiency virus (HIV) in two different hospitals. DESIGN:Prospective, observational study. SETTING:Specialized HIV inpatient units. PATIENTS:HIV-infected inpatients at Cook County Hospital (CCH) and Rush Presbyterian St. Luke's Medical Center (RPSLMC). INTERVENTIONS:A clinical and epidemiologic assessment of patient risk factors for C. difficile was performed. C. difficile isolates found on stool, rectal, and environmental cultures were typed by pulsed-field gel electrophoresis. RESULTS:Twenty-seven percent of patients admitted to CCH versus 4% of patients admitted to RPSLMC had positive cultures for C. difficile (P = .001). At CCH, 14.7% of environmental cultures were positive versus 2.9% at RPSLMC (P = .002). Risk factors for C. difficile acquisition included hospitalization at CCH, more severe HIV, use of acyclovir and H2-blockers, and longer hospital stay. Patients admitted to CCH were taking more antibiotics, had longer hospital stays, and more frequently had a history of C. difficile infection. During the study, two strains (CD1A and CD4) extensively contaminated the CCH environment. However, only CD1A caused an outbreak. CONCLUSIONS:The C. difficile acquisition rate at CCH was sevenfold higher than that at RPSLMC, and CCH had a more contaminated environment. Differences in patient acquisition rates likely reflect a greater prevalence of traditional C. difficile risk factors and a concurrent outbreak at CCH. Although two strains heavily contaminated the environment at CCH, only one caused an outbreak, suggesting that factors other than the environment are important in initiating C. difficile outbreaks.
journal_name
Infect Control Hosp Epidemioljournal_title
Infection control and hospital epidemiologyauthors
Pulvirenti JJ,Gerding DN,Nathan C,Hafiz I,Mehra T,Marsh D,Kocka F,Rice T,Fischer SA,Segreti J,Weinstein RAdoi
10.1086/501987subject
Has Abstractpub_date
2002-11-01 00:00:00pages
641-7issue
11eissn
0899-823Xissn
1559-6834pii
S0195941700078723journal_volume
23pub_type
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
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abstract:OBJECTIVE:To establish a new, rapid, and reliable genotypic fingerprinting technique for methicillin-resistant Staphylococcus aureus (MRSA) typing in routine epidemiological surveillance. DESIGN:The method is based on polymerase chain reaction (PCR) restriction fragment-length polymorphism (RFLP) following HaeII diges...
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pub_type: 杂志文章,多中心研究
doi:10.1086/499151
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doi:10.1086/648361
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