Abstract:
OBJECTIVE:To determine whether the Society for Healthcare Epidemiology of America (SHEA) and the Infectious Diseases Society of America (IDSA) Clostridioides difficile infection (CDI) severity criteria adequately predicts poor outcomes. DESIGN:Retrospective validation study. SETTING AND PARTICIPANTS:Patients with CDI in the Veterans’ Affairs Health System from January 1, 2006, to December 31, 2016. METHODS:For the 2010 criteria, patients with leukocytosis or a serum creatinine (SCr) value ≥1.5 times the baseline were classified as severe. For the 2018 criteria, patients with leukocytosis or a SCr value ≥1.5 mg/dL were classified as severe. Poor outcomes were defined as hospital or intensive care admission within 7 days of diagnosis, colectomy within 14 days, or 30-day all-cause mortality; they were modeled as a function of the 2010 and 2018 criteria separately using logistic regression. RESULTS:We analyzed data from 86,112 episodes of CDI. Severity was unclassifiable in a large proportion of episodes diagnosed in subacute care (2010, 58.8%; 2018, 49.2%). Sensitivity ranged from 0.48 for subacute care using 2010 criteria to 0.73 for acute care using 2018 criteria. Areas under the curve were poor and similar (0.60 for subacute care and 0.57 for acute care) for both versions, but negative predictive values were >0.80. CONCLUSIONS:Model performances across care settings and criteria versions were generally poor but had reasonably high negative predictive value. Many patients in the subacute-care setting, an increasing fraction of CDI cases, could not be classified. More work is needed to develop criteria to identify patients at risk of poor outcomes.
journal_name
Infect Control Hosp Epidemioljournal_title
Infection control and hospital epidemiologyauthors
Stevens VW,Shoemaker HE,Jones MM,Jones BE,Nelson RE,Khader K,Samore MH,Rubin MAdoi
10.1017/ice.2020.8subject
Has Abstractpub_date
2020-05-01 00:00:00pages
510-516issue
5eissn
0899-823Xissn
1559-6834pii
S0899823X20000082journal_volume
41pub_type
杂志文章abstract:OBJECTIVE:To describe the use of laminar airflow, body exhaust, and ultraviolet lights during total knee replacement (TKR) in four U.S. states. DESIGN:Survey of healthcare facilities. SETTING:Hospitals in Illinois, North Carolina, Ohio, and Tennessee that performed TKR during 2000 as identified by Medicare claims dat...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,多中心研究
doi:10.1086/505452
更新日期:2005-12-01 00:00:00
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journal_title:Infection control and hospital epidemiology
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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
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更新日期:2016-08-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/501978
更新日期:2002-10-01 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:2018-05-01 00:00:00
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journal_title:Infection control and hospital epidemiology
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更新日期:2014-11-01 00:00:00
abstract::From 2000 to 2009, rates of multidrug-resistant Acinetobacter baumanii increased 10-fold to 0.2 per 1,000 patient days. From 2010 to 2015, however, rates markedly declined and have stayed below 0.05 per 1,000 patient days. Herein, we present a 15-year trend analysis and discuss interventions that may have led to the d...
journal_title:Infection control and hospital epidemiology
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更新日期:2018-05-01 00:00:00
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journal_title:Infection control and hospital epidemiology
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doi:10.1017/ice.2019.265
更新日期:2019-12-01 00:00:00
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journal_title:Infection control and hospital epidemiology
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doi:10.1086/646187
更新日期:1990-07-01 00:00:00
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journal_title:Infection control and hospital epidemiology
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/651665
更新日期:2010-05-01 00:00:00
abstract:OBJECTIVE:To determine the motivating and behavioral factors responsible for improving compliance with hand washing among physicians. DESIGN:Five unobtrusive, observational studies recording hand washing after direct patient contact, with study results reported to physicians. SETTING:A 450-bed hospital in a health ma...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/501965
更新日期:2002-01-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/503344
更新日期:2006-04-01 00:00:00
abstract::OBJECTIVE To analyze whether electronically available comorbid conditions are risk factors for Centers for Disease Control and Prevention (CDC)-defined, hospital-onset Clostridium difficile infection (CDI) after controlling for antibiotic and gastric acid suppression therapy use. PATIENTS Patients aged ≥18 years admit...
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pub_type: 杂志文章
doi:10.1017/ice.2018.10
更新日期:2018-03-01 00:00:00
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pub_type: 杂志文章
doi:10.1017/ice.2015.127
更新日期:2015-09-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/645834
更新日期:1988-05-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646998
更新日期:1995-01-01 00:00:00
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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
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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::At a university hospital in Japan, the introduction of prospective surveillance and subsequent interventions was effective in reducing the rate of surgical site infection associated with elective colorectal surgery from 27.5% to 17.8% of surgeries. Japan should both recognize the importance of broader surveillance for...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/504444
更新日期:2006-05-01 00:00:00
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更新日期:2020-10-01 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:2017-11-01 00:00:00
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pub_type: 杂志文章
doi:10.1086/593208
更新日期:2009-02-01 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:2018-01-01 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:2019-08-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/501672
更新日期:1999-08-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/512632
更新日期:2007-04-01 00:00:00
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pub_type: 杂志文章
doi:10.1017/ice.2014.37
更新日期:2015-02-01 00:00:00
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journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/508835
更新日期:2007-03-01 00:00:00