Abstract:
:OBJECTIVE Clostridium difficile infection (CDI) is a common hospital-acquired infection. Previous reports on the incidence, risk factors, and impact of CDI on resources in the surgical population are limited. In this context, we study CDI across diverse surgical settings. METHODS We prospectively identified patients with laboratory-confirmed postoperative CDI after 40 different general, vascular, or gynecologic surgeries at 52 academic and community hospitals between July 2012 and September 2013. We used multivariable regression models to identify CDI risk factors and to determine the impact of CDI on resource utilization. RESULTS Of 35,363 patients, 179 (0.51%) developed postoperative CDI. The highest rates of CDI occurred after lower-extremity amputation (2.6%), followed by bowel resection or repair (0.9%) and gastric or esophageal operations (0.7%). Gynecologic and endocrine operations had the lowest rates (0.1% and 0%, respectively). By multivariable analyses, older age, chronic immunosuppression, hypoalbuminemia (≤3.5 g/dL), and preoperative sepsis were associated with CDI. Use of prophylactic antibiotics was not independently associated with CDI, neither was sex, body mass index (BMI), surgical priority, weight loss, or comorbid conditions. Three procedure groups had higher odds of postoperative CDI: lower-extremity amputations (adjusted odds ratio [aOR], 3.5; P=.03), gastric or esophageal operations (aOR, 2.1; P=.04), and bowel resection or repair (aOR, 2; P=.04). Postoperative CDI was independently associated with increased length of stay (mean, 13.7 d vs 4.5 d), emergency department presentations (18.9 vs 9.1%) and readmissions (38.9% vs 7.2%, all P<.001). CONCLUSIONS Incidence of postoperative CDI varies by surgical procedure. Postoperative CDI is also associated with higher rates of extended length of stay, emergency room presentations, and readmissions, which places a potentially preventable burden on hospital resources.
journal_name
Infect Control Hosp Epidemioljournal_title
Infection control and hospital epidemiologyauthors
Abdelsattar ZM,Krapohl G,Alrahmani L,Banerjee M,Krell RW,Wong SL,Campbell DA,Aronoff DM,Hendren Sdoi
10.1017/ice.2014.8subject
Has Abstractpub_date
2015-01-01 00:00:00pages
40-6issue
1eissn
0899-823Xissn
1559-6834pii
S0899823X14000087journal_volume
36pub_type
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journal_title:Infection control and hospital epidemiology
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abstract::We describe the clinical, microbiologic, and molecular features of the first series of qacA/B-containing strains of methicillin-resistant Staphylococcus aureus from infected US patients. All qac-carrying strains were clonally diverse, and qacA strains exhibited increased tolerance to chlorhexidine as measured by minim...
journal_title:Infection control and hospital epidemiology
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abstract:OBJECTIVE:To evaluate clonal dissemination of methicillin-resistant coagulase-negative staphylococci (CNS). SETTING:Neonatal intensive care unit of a 180-bed, university-affiliated general hospital. PATIENTS:Neonates admitted to the neonatal intensive care unit between March 1999 and October 2000, from whom CNS were ...
journal_title:Infection control and hospital epidemiology
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更新日期:2002-08-01 00:00:00
abstract:OBJECTIVE:To describe an outbreak of hepatitis C in a clinical research study. DESIGN:Observational study. SETTING:Tertiary-care hospital. PATIENTS:Healthcare workers who volunteered to be subjects in a study of the metabolic effects of inhaled and oral corticosteroids who were unwittingly exposed to hepatitis C vir...
journal_title:Infection control and hospital epidemiology
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doi:10.1086/501848
更新日期:2001-11-01 00:00:00
abstract::An outbreak of metallo-β-lactamase (MBL) producing Klebsiella pneumoniae occurred at a children's hospital in Japan. MBL-producing K. pneumoniae was detected in tea dispenser in the hospital, the use of which was associated with the acquisition of the MBL-producing Enterobacteriaceae. The outbreak ceased after use of ...
journal_title:Infection control and hospital epidemiology
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doi:10.1017/ice.2018.331
更新日期:2018-12-27 00:00:00
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journal_title:Infection control and hospital epidemiology
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doi:10.1086/502326
更新日期:2004-11-01 00:00:00
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journal_title:Infection control and hospital epidemiology
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doi:10.1086/646308
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journal_title:Infection control and hospital epidemiology
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doi:10.1017/ice.2018.236
更新日期:2018-12-01 00:00:00
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journal_title:Infection control and hospital epidemiology
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doi:10.1086/647890
更新日期:1998-09-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,多中心研究
doi:10.1086/502503
更新日期:2005-10-01 00:00:00
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doi:10.1086/505917
更新日期:2006-07-01 00:00:00
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journal_title:Infection control and hospital epidemiology
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doi:10.1086/590124
更新日期:2008-09-01 00:00:00
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doi:10.1086/646281
更新日期:1991-12-01 00:00:00
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doi:10.1086/646420
更新日期:1992-01-01 00:00:00
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doi:10.1086/597546
更新日期:2009-06-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/502514
更新日期:2005-02-01 00:00:00
abstract:OBJECTIVE:To describe the pattern of transmission of SARS-CoV-2 during 2 nosocomial outbreaks of COVID-19 with regard to the possibility of airborne transmission. DESIGN:Contact investigations with active case finding were used to assess the pattern of spread from 2 COVID-19 index patients. SETTING:A community hospit...
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更新日期:2020-07-03 00:00:00
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doi:10.1086/673444
更新日期:2013-11-01 00:00:00
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doi:10.1086/593952
更新日期:2009-02-01 00:00:00
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更新日期:2005-04-01 00:00:00
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doi:10.1086/499166
更新日期:2006-01-01 00:00:00
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更新日期:2010-10-01 00:00:00
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更新日期:2014-10-01 00:00:00
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journal_title:Infection control and hospital epidemiology
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doi:10.1086/501816
更新日期:2000-09-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,评审
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更新日期:2019-11-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/527514
更新日期:2008-03-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
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更新日期:2016-07-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/587971
更新日期:2008-05-01 00:00:00