Abstract:
BACKGROUND:Clostridium difficile infection (CDI) is a reportable hospital metric associated with significant healthcare expenditures. The epidemiology of CDI is pivotal to the implementation of preventative measures. OBJECTIVE:To portray temporal CDI trends in Veterans Health Administration (VA) hospitals. DESIGN:A retrospective analysis of veterans who had stool testing for C. difficile. SETTING:VA acute-care hospitals within the continental United States. METHODS:Data were mined from the VA's Corporate Data Warehouse. CDI is reported per 10,000 patient days. RESULTS:From 2006 to 2016, 472,346 patients had C. difficile testing. Overall, decreases in incidence of total CDI (16.81 to 13.66) and hospital-onset healthcare facility-associated (HO-HCFA) CDI (10.87 to 6.41) were observed. Temporal increases in the incidence of total and HO-HCFA CDI were associated with the increased use of molecular testing (P < .0001). Decreased use of fluoroquinolones (P < .0001), clindamycin (P = .0006), and third-generation cephalosporins (P = .0002) correlated with decreased rates of CDI, but VA mandatory reporting did not influence CDI rates (P = .24). The overall crude 30-day mortality of patients with CDI decreased from 2.17 deaths per 10,000 patient days in 2006 to 1.41 in 2016. The frequency of International Classification of Disease, Ninth/Tenth Revision (ICD-9/10) discharge diagnosis for CDI was 73.3%. CONCLUSION:Molecular testing was associated with increased incidence of CDI. Controlling CDI is likely multifactorial. Although the VA initiative to report cases of hospital-acquired CDI was not significant in our model, the advent of stewardship programs throughout the VA and reductions in the use of third-generation cephalosporins, fluoroquinolones, and clindamycin were significantly associated with reduced rates of CDI.
journal_name
Infect Control Hosp Epidemioljournal_title
Infection control and hospital epidemiologyauthors
Sumon ZE,Lesse AJ,Sellick JA,Tetewsky S,Mergenhagen KAdoi
10.1017/ice.2019.281subject
Has Abstractpub_date
2020-01-01 00:00:00pages
44-51issue
1eissn
0899-823Xissn
1559-6834pii
S0899823X19002812journal_volume
41pub_type
杂志文章abstract:OBJECTIVE:To study the relationship between serum high-density lipoprotein cholesterol (HDL-C), total serum cholesterol, and nosocomial infection in patients undergoing general surgery. DESIGN:Prospective cohort study, with an extended follow-up to 1 month after hospital discharge. SETTING:The general surgery service...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/647494
更新日期:1997-01-01 00:00:00
abstract::The Food and Drug Administration (FDA) healthcare personnel handwash procedure allows for the use of a non-neutralizing stripping fluid after washing with an antimicrobial handwash product. The antimicrobial in the handwash product can remain active up until the time of neutralization or plating. A modified healthcare...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646101
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abstract:OBJECTIVE:Multidrug-resistant Enterobacteriaceae pose a serious infection control challenge and have emerged as a public health threat. We examined national trends in the proportion of Klebsiella pneumoniae isolates resistant to carbapenems (CRKP) and third-generation cephalosporins (G3CRKP). DESIGN AND SETTING:Retros...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/669523
更新日期:2013-03-01 00:00:00
abstract::OBJECTIVES Hospital-acquired infections (HAIs) develop rapidly after brief and transient exposures, and ecological exposures are central to their etiology. However, many studies of HAIs risk do not correctly account for the timing of outcomes relative to exposures, and they ignore ecological factors. We aimed to descr...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,评审
doi:10.1017/ice.2015.312
更新日期:2016-04-01 00:00:00
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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:BACKGROUND:Pathogens can survive for extended periods when incorporated into biofilm on dry hospital surfaces (ie, dry-surface biofilm, DSB). Bacteria within biofilm are protected from desiccation and have increased tolerance to cleaning agents and disinfectants. OBJECTIVE:We hypothesized that gloved hands of healthca...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
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更新日期:2019-01-01 00:00:00
abstract:OBJECTIVE:To determine the frequency and type of nosocomial infections (NIs) (especially surgical-site infections [SSIs]), risk factors, and the type and duration of antibiotic use among surgical patients in Greek hospitals. DESIGN:Two point-prevalence studies. SETTING:Fourteen Greek hospitals. PATIENTS:Those in the...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,多中心研究
doi:10.1086/502399
更新日期:2004-04-01 00:00:00
abstract:OBJECTIVE:Reduce the frequency of contaminated blood cultures that meet National Healthcare Safety Network definitions for a central line-associated bloodstream infection (CLABSI). DESIGN:An observational study. SETTING:A 500-bed university-affiliated hospital. METHODS:A new blood culture policy discouraged drawing ...
journal_title:Infection control and hospital epidemiology
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doi:10.1086/673142
更新日期:2013-10-01 00:00:00
abstract::Although Corynebacterium minutissimum is well-known as the cause of erythrasma, it is noted as the etiologic agent of nondermatologic disease only rarely. We document this organism as a cause of central venous catheter-associated bacteremia and report the use of pulsed-field gel electrophoresis to characterize its mol...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,评审
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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:2008-08-01 00:00:00
abstract:OBJECTIVE:To determine whether the molecular epidemiological characteristics of methicillin-resistant Staphylococcus aureus (MRSA) had changed in a level III neonatal intensive care unit (NICU). DESIGN:Retrospective review of medical records. SETTING:Level III NICU of a university-affiliated children's hospital in Ne...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/652526
更新日期:2010-06-01 00:00:00
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 Presbyte...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/501987
更新日期:2002-11-01 00:00:00
abstract::In a prospective study, cultures were obtained of all intravascular catheters removed from children in an intensive care unit. Of 366 catheters removed from 217 children, 110 (30%) were found to be colonized, most commonly with coagulase-negative staphylococci. Despite the high rate of colonization, there were only ni...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/647625
更新日期:1997-05-01 00:00:00
abstract::In implementing a hospital mandatory influenza vaccination policy, we developed an automated, real-time tracking and reminder system. Of 6,957 policy-covered individuals automatically identified, automated reminders left only 5 requiring counseling. This decreased Occupational Health workload in contacting noncomplian...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/678415
更新日期:2014-11-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646135
更新日期:1990-03-01 00:00:00
abstract::We created a 2013 combination antibiogram of healthcare-associated urinary tract infection. The 2013 antibiogram-determined regimen was evaluated in a 2014 cohort who had received empirical therapy. The regimen was statistically more likely to represent adequate treatment than actual prescriptions. A customized antibi...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
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更新日期:2016-09-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/591861
更新日期:2008-11-01 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,随机对照试验
doi:10.1017/ice.2017.268
更新日期:2018-02-01 00:00:00
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pub_type: 杂志文章
doi:10.1086/652450
更新日期:2010-05-01 00:00:00
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doi:10.1086/595692
更新日期:2009-03-01 00:00:00
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doi:10.1086/678069
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更新日期:2006-05-01 00:00:00
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doi:10.1086/507284
更新日期:2006-09-01 00:00:00
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更新日期:2020-09-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646510
更新日期:1992-04-01 00:00:00
abstract::BACKGROUND The National Healthcare Safety Network (NHSN) catheter-associated urinary tract infection (CAUTI) definition was revised as of January 2015 to exclude funguria and lower bacteriuria levels. We evaluated the effect of the CAUTI definition change on NHSN-defined central-line-associated bloodstream infection (...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2017.41
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:10.1017/ice.2017.37
更新日期:2017-06-01 00:00:00
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pub_type: 杂志文章
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更新日期:2007-08-01 00:00:00
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