Infection control practices related to Clostridium difficile infection in acute care hospitals in Canada

Gravel, Denise; Gardam, Michael; Taylor, Geoffrey; Miller, Mark A.; Simor, Andrew E.; McGeer, Allison; Hutchinson, James; Moore, Dorothy; Kelly, Sharon M.; Mulvey, Michael R.

doi:10.1016/j.ajic.2008.07.012

Cited by 21 publications

(16 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Crum-Cianflone et al [1] provide convincing evidence that there has been a steady decrease in CD4 + cell counts among individuals with human immunodeficiency virus (HIV) who recently underwent seroconversion and some evidence that this decrease may now be slowing down. They argue that the most likely explanation is that the virus has evolved over time.…”

Section: Consequences Of Early Treatment For Individuals At Risk Of Hmentioning

confidence: 96%

“…As the set-point viral load increases, there is an increase in rate of transmission of HIV infection [3], CD4 + cell count loss [1], and mortality [4]. In epidemics of sexually transmitted HIV infection, the number of cases of HIV infection resulting from a particular case of HIV infection…”

Section: Consequences Of Early Treatment For Individuals At Risk Of Hmentioning

confidence: 99%

“…The testing methods in our hospitals during this surveillance period have been described elsewhere [1]. Six different laboratory methods were used to detect C. difficile toxin in patient's stool.…”

Section: Reply To Bayardellementioning

confidence: 99%

See 2 more Smart Citations

Reply to Bayardelle

Gravel

2009

CLIN INFECT DIS

Self Cite

View full text Add to dashboard Cite

Section: Consequences Of Early Treatment For Individuals At Risk Of Hmentioning

confidence: 96%

Section: Consequences Of Early Treatment For Individuals At Risk Of Hmentioning

confidence: 99%

See 1 more Smart Citation

Reply to Bayardelle

Gravel

2009

CLIN INFECT DIS

Self Cite

View full text Add to dashboard Cite

“…No respondent continued additional CP until discharge. 96 Johnson et al 97 performed a prospective, controlled study of the use of universal gloves on the incidence of CDI and C. difficile colonization. They found that the units in which the glove intervention was performed demonstrated a decrease of C. difficile incidence from 7.7 to 1.5 cases per 1,000 patient discharges (P = .015).…”

Section: Shedding Timementioning

confidence: 99%

Duration of Contact Precautions for Acute-Care Settings

Banach

Bearman

Barnden³

et al. 2018

Infect. Control Hosp. Epidemiol.

View full text Add to dashboard Cite

purposeThis expert guidance document (EG) provides recommendations regarding discontinuation of contact precautions (CP) at the individual patient level in acute-care hospitals employing CP for 1 or more of the following organisms: methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), Clostridium difficile, and multidrug-resistant Enterobacteriaceae (MDR-E), including carbapenem-resistant Enterobacteriaceae (CRE) and extended-spectrum β-lactamase (ESBL)-producing organisms. This document also provides a review of the role of molecular testing in guiding decisions pertaining to duration of CP for patients with these organisms. The guidance does not address decisions regarding the initiation of CP for any specific organism.Previously published guidelines describe components of CP and identify situations in which CP should be used; currently, however, few publications address the issue of how long CP should be maintained. At the time of publication, decisions related to implementation of CP for select, endemic organisms are made by individual facilities based on factors such as institutional epidemiology, resources, organizational priorities, and previously published guidance, and these vary widely. The SHEA Guidelines Committee (GLC) selected this topic to address when CP should be discontinued for individual patients in acute-care settings that employ CP for the aforementioned organisms.Although the organisms addressed are frequently encountered in other settings (eg, nursing homes, long-term acute-care facilities, rehabilitation centers, outpatient medical care settings), additional considerations may affect the application of these recommendations outside the acute-care hospital environment. authorsThe authors consist of current and past members of the SHEA Guidelines Committee (GLC), who serve as volunteers. All authors are involved at their respective institutions in the development of policies pertaining to CP, either directly or in an advisory role. intended useSpecial-topic EG documents are developed to address areas of relatively narrow scope that lack the level of evidence required for a formal guideline but are important for the provision of safe and effective healthcare. As such, systematic grading of evidence level is not provided for individual recommendations. Each EG is based on a synthesis of limited evidence, theoretical rationale, current practices, practical considerations, the opinion of the writing group, and consideration of potential harms where applicable. Within the EG, a summary list of recommendations is provided, along with their respective rationales. We also conducted a survey of the SHEA Research Network (SRN).No EG can anticipate all situations and this EG is not meant to be a substitute for individual judgment by qualified professionals. methods Expert Guidance DevelopmentThis EG follows the process outlined in the Handbook for SHEA-Sponsored Guidelines and Expert Guidance Documents. 10 The topic of duration of CP was among those proposed and ...

show abstract

“…A national survey in Canada identified an extensive lack of antimicrobial stewardship programmes, less than 25% of the 33 participating hospitals [14] in 2005. More recently, attention was drawn to the lack of clinical awareness and testing [15], disparities in the strength of recommendations across different IPC guidelines [16], and the lack of knowledge on the independent effects of common IPC strategies [17–19].…”

mentioning

confidence: 99%

Infection prevention and control of Clostridium difficile: a global review of guidelines, strategies, and recommendations

Balsells¹,

Filipescu²,

Kyaw³

et al. 2016

Journal of Global Health

View full text Add to dashboard Cite

BackgroundClostridium difficile is the leading cause of health care–associated infections. Given the high incidence of C. difficile infection (CDI) and the lack of primary prevention through immunization, health care professionals should be aware of the most current guidance, as well as strengths and limitations of the evidence base underpinning this guidance.MethodsWe identified publicly available national or organizational guidelines related to CDI infection and prevention control (IPC) published between 2000 and 2015 and for any health care setting through an internet search using the Google search engine. We reviewed CDI–targeted IPC recommendations and describe the assessment of evidence in available guidelines.ResultsWe identified documents from 28 countries/territories, mainly from acute care hospitals in North America, the Western Pacific, and Europe (18 countries). We identified only a few specific recommendations for long–term care facilities (LTCFs) and from countries in South America (Uruguay and Chile), South East Asia (Thailand), and none for Africa or Eastern Mediterranean. Of 10 IPC areas, antimicrobial stewardship was universally recognized as essential and supported by high quality evidence. Five other widely reported “strong” recommendations were: effective environment cleaning (including medical equipment), case isolation, use of personal protective equipment, surveillance, and education. Several unresolved and emerging issues were documented and currently available evidence was classified mainly as of mixed quality.ConclusionOur review underlines the need for targeted CDI IPC guidelines in several countries and for LTCFs. International harmonisation on the assessment of the evidence for best practices is needed as well as more robust evidence to support targeted recommendations.

show abstract

Infection control practices related to Clostridium difficile infection in acute care hospitals in Canada

Cited by 21 publications

References 31 publications

Reply to Bayardelle

Reply to Bayardelle

Duration of Contact Precautions for Acute-Care Settings

Infection prevention and control of Clostridium difficile: a global review of guidelines, strategies, and recommendations

Contact Info

Product

Resources

About