Abstract:
OBJECTIVE:The molecular epidemiology of pediatric Clostridium difficile infection (CDI) is poorly understood. We aimed to identify the restriction endonuclease analysis (REA) groups causing CDI and to determine risk factors and outcomes associated with CDI caused by epidemic strains in children. DESIGN:Retrospective cohort study. PATIENTS:Inpatients and outpatients >1 year old receiving care between December 2012 and December 2013. SETTING:An academic children's hospital in Chicago, Illinois. METHODS:C. difficile PCR-positive stools were cultured, and C. difficile isolates were typed by REA. REA of isolates from patients with multiple CDIs was performed to differentiate relapse (infection with same strain) from reinfection (different strains) irrespective of time between CDIs. RESULTS:A total of 189 CDIs occurred among 145 patients. REA groups were widely distributed. The BI/NAP1/027 strain caused CDI in only 1 patient. DH/NAP11/106, the predominant epidemic strain identified, was associated with the use of third- or fourth-generation cephalosporins (risk ratio [RR], 3.2; 95% confidence interval [CI], 1.1-9.9; P=.04). CDI relapse commonly occurred up to 20 weeks later. Compared with CDI caused by non-DH/NAP11/106 strains, CDI caused by DH/NAP11/106 was more likely to result in multiple CDI relapses (40% vs 8%; P=.05) among children with multiple CDIs. CONCLUSIONS:REA identified the exceedingly low prevalence of BI/NAP1/027 and the high prevalence of DH/NAP11/106, a common epidemic strain in the United Kingdom that is less often reported in the United States. CDI relapse commonly occurred up to 20 weeks from the previous CDI. Defining recurrent CDI as that occurring only within 8 weeks of the original infection may lead to misclassification of some recurrent CDIs as new CDIs in children.
journal_name
Infect Control Hosp Epidemioljournal_title
Infection control and hospital epidemiologyauthors
Kociolek LK,Patel SJ,Shulman ST,Gerding DNdoi
10.1017/ice.2014.89subject
Has Abstractpub_date
2015-04-01 00:00:00pages
445-51issue
4eissn
0899-823Xissn
1559-6834pii
S0899823X14000890journal_volume
36pub_type
杂志文章abstract:OBJECTIVE:To study colonization with methicillin-resistant Staphylococcus aureus in a home care service during a 4-month period. DESIGN:Prospective study. SETTING:A home care service located in Rio de Janeiro, Brazil. PARTICIPANTS:Patients admitted to the home care service during this period, their household contact...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/507921
更新日期:2006-10-01 00:00:00
abstract::A retrospective, propensity-matched cohort study was conducted to determine the mortality rate in patients with healthcare-associated infection (HAI) due to multidrug-resistant (MDR) Acinetobacter baumannii. The 28-day mortality rate for patients with MDR A. baumannii HAI was not significantly different than that for ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/591456
更新日期:2008-11-01 00:00:00
abstract:OBJECTIVE:To investigate and control an outbreak of colonization and infection caused by vancomycin-resistant enterococci (VRE) in a burn intensive care unit (BICU). DESIGN:Epidemiological investigation, including multiple point-prevalence culture surveys of patients and environment, cultures from hands of healthcare ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/501806
更新日期:2000-09-01 00:00:00
abstract::Twelve nosocomial outbreaks over 14 years at a tertiary-care center in Mexico are described. Overall mortality was 25.8%, one half due to pneumonia. The most common organism was Pseudomonas aeruginosa. Incidence was three outbreaks per 10,000 discharges; outbreak-related infections comprised 1.56% of all nosocomial in...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/501800
更新日期:2000-08-01 00:00:00
abstract::The geriatric population represents the largest reservoir of Mycobacterium tuberculosis infection in developed nations, including the United States. Tuberculosis (TB) case rates in the United States are highest for this age group compared with other age categories. The subtle clinical manifestations of TB in the elder...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/501816
更新日期:2000-09-01 00:00:00
abstract:OBJECTIVE:Surveillance of nosocomial infections (NIs) is well established in many countries but often does not include gastrointestinal infections. We sought to determine the proportion of NIs among all hospitalized cases for the 4 most prevalent types of gastrointestinal infections in Germany. METHODS:We analyzed all...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/657133
更新日期:2010-12-01 00:00:00
abstract::We report on healthcare worker use of a safe zone (outside a 3-foot perimeter around the patient's bed) and personal protective equipment in 2 inpatient spinal cord injury/disorder units. Workers remained within the safe zone during 22% of observations but were less compliant with personal protective equipment inside ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2016.37
更新日期:2016-06-01 00:00:00
abstract:OBJECTIVE:The quality of environmental hygiene in hospitals is under increasing scrutiny from both healthcare providers and consumers because the prevalence of serious infections due to multidrug-resistant pathogens has reached alarming levels. On the basis of the results from a small number of hospitals, we undertook ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,多中心研究
doi:10.1086/524329
更新日期:2008-01-01 00:00:00
abstract::We reviewed the published data on the possible impact of medical injections and blood transfusions on the spread of human immunodeficiency virus (HIV) in Africa. We also compared these results to our experience in Rwanda, central Africa. The importance of medical injections in the epidemic of HIV infection seems to di...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/645833
更新日期:1988-05-01 00:00:00
abstract::More than 90% of Thai hospitals surveyed reported implementing environmental cleaning and disinfection (ECD) protocols. Hospital epidemiologist presence was associated with the existence of an ECD checklist (P=.01) and of ECD auditing (P=.001), while good and excellent hospital administrative support were associated w...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2017.171
更新日期:2017-10-01 00:00:00
abstract:OBJECTIVE:The incidence of extended-spectrum beta-lactamase (ESbetaL)-mediated resistance has increased markedly during the past decade. Risk factors for colonization with ESbetaL-producing Escherichia coli and Klebsiella species (ESbetaL-EK) remain unclear, as do methods to control their further emergence. DESIGN:Cas...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/502045
更新日期:2002-05-01 00:00:00
abstract:OBJECTIVE:To describe the epidemiology, interventions, and molecular typing methods used during the investigation and control of concurrent outbreaks of Serratia marcescens and methicillin-resistant Staphylococcus aureus (MRSA) infections in a neonatal intensive-care unit (NICU). SETTING:A 206-bed women's and infants'...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:
更新日期:1998-12-01 00:00:00
abstract::Due to the rapid transfer of patients from the acute-care setting, the intensity of nursing care among residents in long-term-care facilities (LTCFs) has increased, transforming today's LTCFs into subacute healthcare facilities. Given the increased risk of infection among residents in LTCFs and the associated morbidit...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/501581
更新日期:1999-11-01 00:00:00
abstract:OBJECTIVE:To investigate prospectively the clinical course and risk factors for ventilator-associated tracheobronchitis (VAT) and the impact of VAT on intensive care unit (ICU) morbidity and mortality. DESIGN:Prospective cohort study. SETTING:University Hospital Larissa, Larissa, Greece. PATIENTS:Critical care patie...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/671274
更新日期:2013-08-01 00:00:00
abstract:OBJECTIVE:To evaluate the prevalence, epidemiologic features, and molecular characteristics of colonization with community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) among hospitalized dialysis patients and their healthcare workers (HCWs). DESIGN:Prospective observational clinical and laboratory ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/592983
更新日期:2009-01-01 00:00:00
abstract::This study was conducted to evaluate the effect of normal use on latex glove integrity in a flow cytometry laboratory. The gloves were tested using the 1,000 microL water-tight test and met industrial standards (less than 4% leakage) before, but not after use. More durable gloves, or more frequent changes of gloves, m...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/647643
更新日期:1997-06-01 00:00:00
abstract:OBJECTIVE:To determine the comparative virulence of methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-sensitive S aureus (MSSA) by consideration of predisposing factors and outcomes in patients infected with these organisms in the healthcare setting. DESIGN:Analysis of an historical cohort of 504 bact...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/501707
更新日期:2000-10-01 00:00:00
abstract::Hospital epidemiologists have an opportunity to apply their skills to hospital quality problems other than infection control. Soon, hospitals will be required to collect and report numerous quality indicators, whose results will require epidemiologic interpretation. For those who choose to make the transition into qua...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/647065
更新日期:1995-02-01 00:00:00
abstract:OBJECTIVE:To develop a method for selecting health care-associated infection (HAI) measures for public reporting. CONTEXT:HAIs are common, serious, and costly adverse outcomes of medical care that affect 2 million people in the United States annually. Thirty-seven states have introduced or passed legislation requiring...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/660873
更新日期:2011-08-01 00:00:00
abstract:OBJECTIVE:To determine the rates of and risk factors for carriage and acquisition of extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae during hospitalization. DESIGN:Cohort study. SETTING:Shaare Zedek Medical Center, a 550-bed teaching hospital. METHODS:During a 5-month period (February 1-June 30,...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/597505
更新日期:2009-06-01 00:00:00
abstract:OBJECTIVES:Current efforts to contain anti-microbial costs in hospitals are based on restricting drugs. We explored the effects of unsolicited case-specific recommendations to physicians to discontinue parenteral antimicrobial therapy in medically stable patients with pneumonia, in order to shorten hospital length of s...
journal_title:Infection control and hospital epidemiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1086/646419
更新日期:1992-01-01 00:00:00
abstract::An organic load of 5%-10% fetal calf serum significantly reduced hypochlorite and UV radiation killing of Clostridium difficile spores, but organic material collected from hospital surfaces did not affect hypochlorite and only modestly affected UV killing of spores. Hypochlorite reduced aerobic microorganisms on uncle...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/673148
更新日期:2013-10-01 00:00:00
abstract::The cumulative risk of human immunodeficiency virus (HIV) infection over a healthcare career has rarely been estimated, but is more relevant to the description of an occupational hazard than the risk of seroconversion from a single exposure. We describe a model for assessing the individualized risk for HIV infection a...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646161
更新日期:1990-05-01 00:00:00
abstract:OBJECTIVE:To identify patient-care practices related to an increased prevalence of hepatitis C virus (HCV) infection among chronic hemodialysis patients. DESIGN:Survey. SETTING:Chronic hemodialysis facilities in the United States. PARTICIPANTS:Equal-probability 2-stage cluster sampling was used to select 87 faciliti...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/659407
更新日期:2011-05-01 00:00:00
abstract::Hospital antibiotic use in Argentina has not been described. We present results of point prevalence surveys on antibiotic use conducted in 109 Argentinian hospitals in November 2018 and submitted to the National Program of Epidemiology and Control of Hospital-Acquired Infections, and we discuss potential areas for imp...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2019.243
更新日期:2019-11-01 00:00:00
abstract::OBJECTIVE To compare central line use and central line-associated bloodstream infection in newborn infants before and after the introduction of a central line infection prevention bundle in order to determine the effectiveness of the bundle and to identify areas for further improvement. DESIGN Retrospective cohort ana...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2016.127
更新日期:2016-09-01 00:00:00
abstract:OBJECTIVE:To evaluate changing Clostridioides difficile infection (CDI) testing among inpatients with indeterminate enzyme immunoassay (EIA) results (antigen+/toxin-) from reflexive polymerase chain reaction (PCR) testing to clinician-ordered PCR testing. DESIGN:Multicenter, before-and-after, quasi-experimental study....
journal_title:Infection control and hospital epidemiology
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doi:10.1017/ice.2020.56
更新日期:2020-06-01 00:00:00
abstract::How the media communicate and how the scientific community influences the media are important factors to consider in the public health response to emerging pathogens, including methicillin-resistant Staphylococcus aureus. Social representation theory suggests that the media link "the threatening" to commonplace "ancho...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/656000
更新日期:2010-11-01 00:00:00
abstract::We examined contamination of healthcare worker (HCW) gown and gloves after caring for patients with Klebsiella pneumoniae carbapenemase (KPC)-producing and non-KPC-producing Klebsiella as a proxy for horizontal transmission. The rate of contamination with Klebsiella species is similar to that of contamination with met...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/675598
更新日期:2014-04-01 00:00:00
abstract::Thorough counseling with emphasis on the importance of mosquito bite avoidance, as well as on compliance with prophylactic antimalarial regimens, remains an important task for the physician preparing a patient for international travel. Chloroquine continues to be the drug of choice for prophylaxis in areas not reporti...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,评审
doi:10.1086/646703
更新日期:1993-03-01 00:00:00