Impact of real-time notification of Clostridium difficile test results and early initiation of effective antimicrobial therapy

Polen, Christian B.; Judd, William R.; Ratliff, Patrick D.; King, Gregory S.

doi:10.1016/j.ajic.2017.11.010

Cited by 5 publications

(11 citation statements)

References 12 publications

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“…The duration of interventions varied across the studies from three weeks 141 up to six years 143 . The interventions involved various cadres of professionals namely infectious disease (ID) experts 113, 114, 124, 125, 139 , consultants 117, 130, 139, 141, 145 , nurses 113, 125, 127, 128, 130, 133, 134, 137–139, 140, 141, 144, 145 , doctors 116, 123–125, 137 , physicians 112, 113, 115, 117, 118, 122, 124, 127, 128, 133, 138, 139, 141, 143, 145 , pharmacists 112, 115–117, 122, 124–126 , epidemiologists 125, 128, 136, 141 , laboratory personnel 133 , microbiologists 124, 133, 138, 141 , and support staff (cleaners, caregivers, housekeepers, paramedics, porters, environmental officers) 125, 127, 130, 134, 141, 144, 145 . Additional cadres involved include managers 116, 141 , infection control staff 118, 123, 127, 128, 130, 133, 134, 140, 141 , unspecified clinicians/ medical personnel 118–121, 123, 134–137, 138,…”

Section: Resultsmentioning

confidence: 99%

“…Most of the interventions were multi-faceted involving the implementation of at least two strategies to achieve the intended outcomes as highlighted in Table 2. The strategies employed in interventions targeting Clostridium difficile included surveillance and/ or active screening 116, 118, 123 , alerts and notifications 118, 123, 126 , isolation precautions 118, 123, 125–127 , environmental disinfection 121, 125, 127 , audits and feedback 112, 114, 115, 117, 122–124 , antimicrobial policies and/ protocols 113, 116, 122, 126 , care bundles 127 , staff education 113, 114, 116, 122, 125 , and specialised biocidal linen 119, 120 . Table 2 below outlines the combination of these interventions across the identified studies.…”

Section: Resultsmentioning

confidence: 99%

“…32.4% (11) of the studies were conducted in the United States of America 115,118,141,146,[119][120][121][122]124,126,127,136 whereas two studies each are based in Canada 112,114 and Greece 135,137…”

Section: Characteristics Of Selected Studiesmentioning

confidence: 99%

“…Environmental decontamination entailed the use of appropriate decontamination agents to clean the patient environment and reduce the presence of Clostridium difficile. A single centre study combined isolation precautions with a computer generated real time notification system for toxigenic C. difficile results and a treatment protocol using vancomycin only or vancomycin and metronidazole126 . The final study on isolation precautions also incorporated an automated system that tracked C. difficile results and triggered alerts on the patient's electronic records as well as automatically ordering for the appropriate isolation precautions thus aiding the healthcare personnel's actions118 .Three standalone interventions targeted modifying the hospital environment and reduce the bioavailability of Clostridium difficile[119][120][121] .…”

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confidence: 99%

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Antibiotics resistance and mitigation strategies in healthcare settings: A scoping review

Okeah

Huws

Morrison

2020

Preprint

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Background: According to the European Center for Disease Prevention and Control (ECDC), the EU records an estimated 3.2 million healthcare associated infections (HAIs) and an associated 37,000 deaths annually. A significant proportion of the HAIs burden is attributable to multi-drug resistant pathogens. Infectious diseases remain top on the list of the leading causes of death globally with multi-drug resistant microorganisms (MDROs) playing a significant role. Aims: To assess the breadth of studies on antibiotics stewardship C. diff and Klebsiella pneumoniae in healthcare settings. To identify existing literature on the interventions for reducing healthcare associated C. diff and Klebsiella pneumoniae transmission. Methods: This scoping review was undertaken and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols (PRISMA-P) guidelines. The specific databases searched included MEDLINE, PubMed, Web of Science Core Collection, and CINAHL. The process for screening articles and data extraction was undertaken in duplicate by two reviewers. A narrative synthesis of the results is provided. Results: The review included 34 studies (16 studies on Clostridium difficile and 18 articles focussed on Klebsiella pneumoniae). These interventions include Education, Surveillance/Screening, Consultations, Audits, Policies/Protocols, Environmental disinfection, Bundles, Isolation, and Notifications or alerts (ESCAPE-BIN). A study involving screening, alerts, staff education, and antimicrobial protocols recorded a 75% reduction in the use of targeted antimicrobials. The largest absolute reduction in antimicrobial use of 310 DDs/1000PDs was reported from an intervention that involved audits and feedback systems. The highest improvement (95%) in adherence was reported by an intervention involving the use of an infection prevention bundle and an environmental cleaning protocol. Conclusion: Antimicrobial resistance represents a global threat requiring urgent measures to protect lives. Reducing the burden of AMR entails a host of multi-level approaches aimed at curbing transmission of the resistant pathogens, and optimizing the use of antibiotics.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Characteristics Of Selected Studiesmentioning

confidence: 99%

mentioning

confidence: 99%

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Antibiotics resistance and mitigation strategies in healthcare settings: A scoping review

Okeah

Huws

Morrison

2020

Preprint

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“…Early notification by the microbiologist, which was the norm at the vast majority of participating centres, has been associated with early initiation of antibiotic treatment and preventive measures [19].…”

Section: Discussionmentioning

confidence: 99%

Impact of a training program on the surveillance of Clostridioides difficile infection

et al. 2019

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A high degree of vigilance and appropriate diagnostic methods are required to detect Clostridioides difficile infection (CDI). We studied the effectiveness of a multimodal training program for improving CDI surveillance and prevention. Between 2011 and 2016, this program was made available to healthcare staff of acute care hospitals in Catalonia. The program included an online course, two face-to-face workshops and dissemination of recommendations on prevention and diagnosis. Adherence to the recommendations was evaluated through surveys administered to the infection control teams at the 38 participating hospitals. The incidence of CDI increased from 2.20 cases/10 000 patient-days in 2011 to 3.41 in 2016 (P < 0.001). The number of hospitals that applied an optimal diagnostic algorithm rose from 32.0% to 71.1% (P = 0.002). Hospitals that applied an optimal diagnostic algorithm reported a higher overall incidence of CDI (3.62 vs. 1.92, P < 0.001), and hospitals that were more active in searching for cases reported higher rates of hospital-acquired CDI (1.76 vs. 0.84, P < 0.001). The results suggest that the application of a multimodal training strategy was associated with a significant rise in the reporting of CDI, as well as with an increase in the application of the optimal diagnostic algorithm.

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Independent pharmacist prescribing of statins for patients with type 2 diabetes: An analysis of enhanced pharmacist prescriptive authority in Idaho

Spann¹,

Hamper²,

Griffith³

et al. 2020

Journal of the American Pharmacists Association

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Impact of real-time notification of Clostridium difficile test results and early initiation of effective antimicrobial therapy

Cited by 5 publications

References 12 publications

Antibiotics resistance and mitigation strategies in healthcare settings: A scoping review

Antibiotics resistance and mitigation strategies in healthcare settings: A scoping review

Impact of a training program on the surveillance of Clostridioides difficile infection

Independent pharmacist prescribing of statins for patients with type 2 diabetes: An analysis of enhanced pharmacist prescriptive authority in Idaho

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