Chasing the rate: An interrupted time series analysis of interventions targeting reported hospital onset <i>Clostridioides difficile</i>, 2013–2018

Doll, Michelle; Zhao, Jinlei; Kang, Le; Rittmann, Barry; Alvarez, M Pérez; Fleming, Michele; Cooper, Kaila; Stevens, Michael P.; Bearman, Gonzalo

doi:10.1017/ice.2020.247

Cited by 3 publications

(3 citation statements)

References 18 publications

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“…Brite 2018 [13] Low risk Low risk Unclear risk Unclear risk Unclear risk Low risk Low risk Doll 2020 [15] Low risk Low risk Unclear risk Unclear risk Unclear risk Low risk Low risk McCord 2016 [24] Low risk Low risk Unclear risk Unclear risk Unclear risk Low risk Low risk Mitchell 2014 [27] Low risk Low risk Unclear risk Unclear risk Unclear risk Low risk Low risk Murphy 2020 [29] Low risk Low risk Unclear risk Unclear risk Unclear risk Low risk Low risk Pegues 2017 [34] Unclear risk Low risk Unclear risk Unclear risk Unclear risk Low risk Low risk Schaffzin 2020 [38]…”

Section: Other Risks Of Biasmentioning

confidence: 99%

“…J o u r n a l P r e -p r o o f 69 Appendix I -GRADE tables [8] Morikane 2020; [28] Napolitan o 2015; [32] Raggi 2018) [35] Multicentr [8] Attia 2020; [10] Boyce 2008; [11] Boyce 2017; [12] Brite 2018; [13] Green 2017; [16] Haas 2014; [17] Horn 2015; [19] Levin 2013 [22] Manian 2013; [23] McCord 2016; [24] McMullen 2020; [25] Miller 2015; [26] Napolitano [32] Passaretti 2013; [33] Pegues 2017; [34] Sampathkum ar 2019; [37] Vianna 2016) [39] C. difficile infections per 10,000 patient days, UV-C versus standard cleaning/disinfection 1 (Doll 2020) [15] Interrupte [8] Boyce 2017; [12] Green 2017; [16] Haas 2014; [17] Horn 2015; [19] Kitagawa 2021; [20] Mitchell 2014; [27] Morikane 2020; [28] Napolitan o 2015; [32] Passaretti 2013; [33] Raggi 2018; [35] Vianna 2016) [39] Multicentre [8] Boyce 2017; [12] Brite 2018; [13] Haas 2014; [17] Horn 2015; [19] Napolitano 2015; [32] Passaretti 2013; [33] Raggi 2018; [35] S...…”

Section: Model Checking and Interpretationmentioning

confidence: 99%

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Automated room decontamination: report of a Healthcare Infection Society Working Party

Beswick

Fry²,

Bradley

et al. 2022

Journal of Hospital Infection

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Section: Other Risks Of Biasmentioning

confidence: 99%

Section: Model Checking and Interpretationmentioning

confidence: 99%

Automated room decontamination: report of a Healthcare Infection Society Working Party

Beswick

Fry²,

Bradley

et al. 2022

Journal of Hospital Infection

View full text Add to dashboard Cite

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“…10 , [ 101 – 116 ] patient-zone environmental surfaces are frequently contaminated with a wide range of HAPs. While the frequency of contamination is greatest close to patients, genomic epidemiology has confirmed more distance spread [ 11 , 116 ]. While documenting high level CRE contamination (88% of surfaces) associated with colonized patients, the study by Shams also found that 80% of all contamination was associated with 20% of colonized patients which they characterized as “super shedders” [ 101 , 117 ] Although many of the HAI-associated pathogens in Fig.…”

Section: Additional Benefits Of Mitigating CD Environmental Transmissionmentioning

confidence: 99%

Environmental approaches to controlling Clostridioides difficile infection in healthcare settings

Carling,

Parry,

Olmstead

2023

Antimicrob Resist Infect Control

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As today’s most prevalent and costly healthcare-associated infection, hospital-onset Clostridioides difficile infection (HO-CDI) represents a major threat to patient safety world-wide. This review will discuss how new insights into the epidemiology of CDI have quantified the prevalence of C. difficile (CD) spore contamination of the patient-zone as well as the role of asymptomatically colonized patients who unavoidable contaminate their near and distant environments with resilient spores. Clarification of the epidemiology of CD in parallel with the development of a new generation of sporicidal agents which can be used on a daily basis without damaging surfaces, equipment, or the environment, led to the research discussed in this review. These advances underscore the potential for significantly mitigating HO-CDI when combined with ongoing programs for optimizing the thoroughness of cleaning as well as disinfection. The consequence of this paradigm-shift in environmental hygiene practice, particularly when combined with advances in hand hygiene practice, has the potential for significantly improving patient safety in hospitals globally by mitigating the acquisition of CD spores and, quite plausibly, other environmentally transmitted healthcare-associated pathogens.

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Diagnostic stewardship in infectious diseases: a scoping review

Shorten,

Pickering,

Goolden

et al. 2024

Journal of Medical Microbiology

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Introduction. The term ‘diagnostic stewardship’ is relatively new, with a recent surge in its use within the literature. Despite its increasing popularity, a precise definition remains elusive. Various attempts have been made to define it, with some viewing it as an integral part of antimicrobial stewardship. The World Health Organization offers a broad definition, emphasizing the importance of timely, accurate diagnostics. However, inconsistencies in the use of this term still persist, necessitating further clarification. Gap Statement. There are currently inconsistencies in the definition of diagnostic stewardship used within the academic literature. Aim. This scoping review aims to categorize the use of diagnostic stewardship approaches and define this approach by identifying common characteristics and factors of its use within the literature. Methodology. This scoping review undertook a multi-database search from date of inception until October 2022. Any observational or experimental study where the authors define the intervention to be diagnostic stewardship from any clinical area was included. Screening of all papers was undertaken by a single reviewer with 10% verification by a second reviewer. Data extraction was undertaken by a single reviewer using a pre-piloted form. Given the wide variation in study design and intervention outcomes, a narrative synthesis approach was applied. Studies were clustered around common diagnostic stewardship interventions where appropriate. Results. After duplicate removal, a total of 1310 citations were identified, of which, after full-paper screening, 105 studies were included in this scoping review. The classification of an intervention as taking a diagnostic stewardship approach is a relatively recent development, with the first publication in this field dating back to 2017. The majority of research in this area has been conducted within the USA, with very few studies undertaken outside this region. Visual inspection of the citation map reveals that the current evidence base is interconnected, with frequent references to each other’s work. The interventions commonly adopt a restrictive approach, utilizing hard and soft stops within the pre-analytical phase to restrict access to testing. Upon closer examination of the outcomes, it becomes evident that there is a predominant focus on reducing the number of tests rather than enhancing the current test protocol. This is further reflected in the limited number of studies that report on test performance (including protocol improvements, specificity and sensitivity). Conclusion. Diagnostic stewardship seems to have deviated from its intended course, morphing into a rather rudimentary instrument wielded not to enhance but to constrict the scope of testing. Despite the World Health Organization’s advocacy for an ideology that promotes a more comprehensive approach to quality improvement, it may be more appropriate to consider alternative regional narratives when categorizing these types of quality improvement interventions.

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Chasing the rate: An interrupted time series analysis of interventions targeting reported hospital onset Clostridioides difficile, 2013–2018

Cited by 3 publications

References 18 publications

Automated room decontamination: report of a Healthcare Infection Society Working Party

Automated room decontamination: report of a Healthcare Infection Society Working Party

Environmental approaches to controlling Clostridioides difficile infection in healthcare settings

Diagnostic stewardship in infectious diseases: a scoping review

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