Morbidity, Mortality, and Healthcare Burden of Nosocomial<i>Clostridium Difficile</i>-Associated Diarrhea in Canadian Hospitals

Miller, Mark A.; Hyland, Meagan; Ofner-Agostini, Marianna; Gourdeau, Marie; Ishak, Magued

doi:10.1086/502023

Cited by 186 publications

(112 citation statements)

References 16 publications

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“…Surveillance for CDI is limited by the use of nonculture-based methods to diagnose CDI, such as stool toxin assays, which have lower sensitivity than does C. difficile stool culture. [20][21][22][24][25][26][27] 2. Identifying patients with CDI Positive results of diarrheal stool tests for toxigenic C. difficile or its toxins are the most common methods used to identify patients with CDI.…”

Section: Purposementioning

confidence: 99%

“…Identifying patients with CDI Positive results of diarrheal stool tests for toxigenic C. difficile or its toxins are the most common methods used to identify patients with CDI. [20][21][22]24 a. Positive results of diarrheal stool tests should automatically be sent to infection prevention and control professionals and to clinicians caring for the patient.…”

Section: Purposementioning

confidence: 99%

“…The formation of spores has novel (as yet unknown) implications for methods of hand hygiene and environmental disinfection, because C. difficile spores are resistant to the bactericidal effects of alcohol and most hospital disinfectants. c. General strategies to prevent CDI, per previously published guidelines, 22,[24][25][26][27] include the following:…”

Section: Purposementioning

confidence: 99%

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Strategies to Prevent Clostridium difficile Infections in Acute Care Hospitals

Dubberke

Gerding

Classen

et al. 2008

Infect. Control Hosp. Epidemiol.

189

194

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Previously published guidelines are available that provide comprehensive recommendations for detecting and preventing healthcare-associated infections. The intent of this document is to highlight practical recommendations in a concise format designed to assist acute care hospitals in implementing and prioritizing their Clostridium difficile infection (CDI) prevention efforts. Refer to the Society for Healthcare Epidemiology of America/Infectious Diseases Society of America “Compendium of Strategies to Prevent Healthcare-Associated Infections” Executive Summary and Introduction and accompanying editorial for additional discussion.1. Increasing rates of CDIC. difficile now rivals methicillin-resistant Staphylococcus aureus (MRSA) as the most common organism to cause healthcare-associated infections in the United States.a. In the United States, the proportion of hospital discharges in which the patient received the International Classification of Diseases, Ninth Revision discharge diagnosis code for CDI more than doubled between 2000 and 2003, and CDI rates continued to increase in 2004 and 2005 (L. C. McDonald, MD, personal communication, July 2007). These increases have been seen in pediatric and adult populations, but elderly individuals have been disproportionately affected. CDI incidence has also increased in Canada and Europe.b. There have been numerous reports of an increase in CDI severity.c. Most reports of increases in the incidence and severity of CDI have been associated with the BI/NAP1/027 strain of C. difficile. This strain produces more toxins A and B in vitro than do many other strains of C. difficile, produces a third toxin (binary toxin), and is highly resistant to fluoroquinolones.

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Section: Purposementioning

confidence: 99%

Section: Purposementioning

confidence: 99%

Section: Purposementioning

confidence: 99%

See 1 more Smart Citation

Strategies to Prevent Clostridium difficile Infections in Acute Care Hospitals

Dubberke

Gerding

Classen

et al. 2008

Infect. Control Hosp. Epidemiol.

189

194

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“…Al igual que en esta investigación, diversos estudios (3,4,16,22,23) han documentado que esta enfermedad afecta a todos los grupos poblacionales sin distinción de edad ni de sexo, aunque parece presentarse con mayor frecuencia en los adultos mayores de 65 años, en quienes, además, es más agresiva (3,12,22,24).…”

Section: Discussionunclassified

Clinical and demographic profile and risk factors for Clostridium difficile infection

Carvajal¹,

Pacheco²,

Jaimes³

2017

biomedica

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Contribución de los autores:Todos los autores participaron en igual medida en todos los aspectos del estudio y la redacción del manuscrito. Introducción. La enfermedad asociada a Clostridium difficile es la principal causa de diarrea infecciosa adquirida en el hospital; su creciente incidencia, las menores tasas de respuesta al tratamiento inicial y la mayor tasa de recaídas han incrementado la carga de la enfermedad. Objetivo. Determinar las características clínicas de los pacientes hospitalizados con enfermedad asociada a C. difficile. Materiales y métodos. Se hizo un estudio de casos anidado en una cohorte. Se revisaron las historias clínicas de pacientes con diarrea iniciada durante su hospitalización a quienes se les había practicado la prueba de detección de la toxina A-B de C. difficile, entre febrero de 2010 y febrero de 2012. Se definió como caso al paciente hospitalizado con diarrea y prueba de Enzyme Linked Fluorescent Assay (ELFA) positiva para la toxina y, como control, a aquel con resultado negativo para la toxina. Se recolectaron los datos demográficos y clínicos, así como la información sobre los factores asociados, la estancia hospitalaria, el tratamiento y las complicaciones. Perfil clínico y demográfico y factores de riesgo frente a la infección por Clostridium difficileResultados. Durante el periodo de seguimiento se recolectaron datos de 123 pacientes, de los cuales 30 fueron positivos para la toxina. La edad media en la población de estudio fue de 49 años y el 60 % correspondía a hombres. Los síntomas predominantes fueron el dolor abdominal (35 %) y la fiebre (34 %). Las principales complicaciones fueron la alteración electrolítica y la sepsis grave asociada con disfunción renal. La mortalidad total fue de 13 % y los factores independientes asociados con la aparición de la infección fueron el uso de inhibidores de la bomba de protones y la cirugía gastrointestinal previa. Conclusiones. El uso de inhibidores de la bomba de protonesy la cirugía gastrointestinal previa fueron factores asociados con la infección por C. difficile. Clinical and demographic profile and risk factors for Clostridium difficile infectionIntroduction: Clostridium difficile infection is the leading cause of nosocomial infectious diarrhea. The increasing incidence added to a lower rate of response to the initial treatment and higher rates of relapse has generated a higher burden of the disease. Objective: To determine the clinical characteristics of hospitalized patients with C. difficile infection. Materials and methods:We made a nested case-cohort study. We reviewed medical records of the patients with nosocomial diarrhea for whom an assay for toxin A-B of C. difficile had been requested from February, 2010, to February, 2012. We defined case as a patient with diarrhea and a positive assay for the toxin, and control as those patients with a negative assay for the toxin. We collected data on demographic and clinical characteristics, risk factors, hospital length of stay, treatment, and complications. Results: We collec...

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“…A spectrum of disease has been associated with C. difficile, ranging from mild diarrhea to potential fatal complications. Besides pseudomembranous colitis and toxic megacolon, complications, such as hypokalemia, gastrointestinal bleeding, and bowel perforation occur in up to 10% of patients with C. difficile-associated diarrhea (CDAD) [25]. However, residents of nursing homes with C. difficile are most often asymptomatic and will clear their feces by 2 months, although prolonged colonization for 3 months or longer has been observed [26].…”

Section: Clostridium Difficilementioning

confidence: 99%