Abstract:
:OBJECTIVETo evaluate probiotics for the primary prevention of Clostridium difficile infection (CDI) among hospital inpatients.DESIGNA before-and-after quality improvement intervention comparing 12-month baseline and intervention periods.SETTINGA 694-bed teaching hospital.INTERVENTIONWe administered a multispecies probiotic comprising L. acidophilus (CL1285), L. casei (LBC80R), and L. rhamnosus (CLR2) to eligible antibiotic recipients within 12 hours of initial antibiotic receipt through 5 days after final dose. We excluded (1) all patients on neonatal, pediatric and oncology wards; (2) all individuals receiving perioperative prophylactic antibiotic recipients; (3) all those restricted from oral intake; and (4) those with pancreatitis, leukopenia, or posttransplant. We defined CDI by symptoms plus C. difficile toxin detection by polymerase chain reaction. Our primary outcome was hospital-onset CDI incidence on eligible hospital units, analyzed using segmented regression.RESULTSThe study included 251 CDI episodes among 360,016 patient days during the baseline and intervention periods, and the incidence rate was 7.0 per 10,000 patient days. The incidence rate was similar during baseline and intervention periods (6.9 vs 7.0 per 10,000 patient days; P=.95). However, compared to the first 6 months of the intervention, we detected a significant decrease in CDI during the final 6 months (incidence rate ratio, 0.6; 95% confidence interval, 0.4-0.9; P=.009). Testing intensity remained stable between the baseline and intervention periods: 19% versus 20% of stools tested were C. difficile positive by PCR, respectively. From medical record reviews, only 26% of eligible patients received a probiotic per the protocol.CONCLUSIONSDespite poor adherence to the protocol, there was a reduction in the incidence of CDI during the intervention, which was delayed ~6 months after introducing probiotic for primary prevention.Infect Control Hosp Epidemiol 2018;765-770.
journal_name
Infect Control Hosp Epidemioljournal_title
Infection control and hospital epidemiologyauthors
Trick WE,Sokalski SJ,Johnson S,Bunnell KL,Levato J,Ray MJ,Weinstein RAdoi
10.1017/ice.2018.76subject
Has Abstractpub_date
2018-07-01 00:00:00pages
765-770issue
7eissn
0899-823Xissn
1559-6834pii
S0899823X18000764journal_volume
39pub_type
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/501614
更新日期:1999-03-01 00:00:00
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
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doi:10.1086/507921
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/651096
更新日期:2010-04-01 00:00:00
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journal_title:Infection control and hospital epidemiology
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doi:10.1086/592705
更新日期:2009-01-01 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
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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::An outbreak of vancomycin-resistant enterococci (VRE) began at the University of Massachusetts Medical Center in May 1993. As of September 1995, we had a total of 253 patients infected or colonized with VRE, with consequent increasing demand for private rooms. We analyzed results of surveillance cultures for VRE of 49...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,评审
doi:
更新日期:1997-11-01 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::A nonrandomized, retrospective comparison of Staphylococcus aureus bacteremia between an academic hospital setting (n=53) and a community hospital setting (n=245) within a single healthcare system was performed. Despite infectious disease consultations, S. aureus bacteremia management recommendations based on Infectio...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
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更新日期:2017-06-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/647742
更新日期:1998-11-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/501729
更新日期:2000-12-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/606168
更新日期:2009-11-01 00:00:00
abstract::This study reports an investigation of outbreaks of methicillin-resistant Staphylococcus aureus (MRSA) infection and colonization involving 17 newborns in the neonatal unit of a teaching hospital. A neonatal specialist colonized with MRSA that eventually became mupirocin-resistant was implicated as a recurrent source ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/513616
更新日期:2007-05-01 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:10.1017/ice.2018.165
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/647693
更新日期:1997-09-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/508821
更新日期:2007-01-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2018.280
更新日期:2019-01-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2020.8
更新日期:2020-05-01 00:00:00
abstract::We used mandatory public reporting as an impetus to perform a statewide study to define risk factors for surgical site infection. Among women who underwent abdominal hysterectomy, blood transfusion was a significant risk factor for surgical site infection in patients who experienced blood loss of less than 500 mL. ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/663341
更新日期:2012-01-01 00:00:00
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journal_title:Infection control and hospital epidemiology
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doi:10.1086/589906
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journal_title:Infection control and hospital epidemiology
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doi:10.1086/502442
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/668436
更新日期:2012-12-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/665316
更新日期:2012-05-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/675831
更新日期:2014-05-01 00:00:00
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journal_title:Infection control and hospital epidemiology
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更新日期:2015-12-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/501822
更新日期:2001-01-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1086/502073
更新日期:2002-07-01 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
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更新日期:2015-05-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/655441
更新日期:2010-08-01 00:00:00