The epidemiology of <i>Clostridium difficile</i> infection in a national kidney transplant center

Kennedy, Claire; Waldron, Carmel; Skally, Máiréad; Gaughan, Leah; Magee, Colm; Burns, Karen; Fitzpatrick, Fidelma

doi:10.1111/ctr.12962

Cited by 2 publications

(1 citation statement)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, in Denmark, 46% of HA-CDI cases registered in 1 Capital Region in Denmark in 2010–2015 had community-onset of symptoms [24]. However, lower proportions of CO-HA-CDI have been reported in other studies [16, 25], indicating local differences in frailty of the studied population, hospital LOS, CDI awareness in the hospitals or community, circulating ribotypes, and differing healthcare systems. Besides the reported increase in HA-CDI occurring postdischarge, CA-CDI incidence has also been reported to have increased over the last years [26].…”

Section: Discussionmentioning

confidence: 99%

Community-Onset Clostridioides Difficile Infection in Hospitalized Patients in The Netherlands

Crobach

Notermans

Harmanus

et al. 2019

Open Forum Infectious Diseases

View full text Add to dashboard Cite

Background Clostridioides difficile infection (CDI) is increasingly reported in the community. The aim of this study was to analyze characteristics of hospitalized patients with community-onset CDI (CO-CDI).MethodsIn the Netherlands, 24 hospitals (university-affiliated and general hospitals) participate in the sentinel CDI surveillance program. Clinical characteristics and 30-day outcomes of hospitalized patients >2 years old diagnosed with CDI are registered. Samples of these patients are sent to the national reference laboratory for polymerase chain reaction ribotyping. Data obtained for this surveillance from May 2012 to May 2018 were used to compare CO-CDI with hospital-onset (HO)-CDI episodes.ResultsOf 5405 registered cases, 2834 (52.4%) were reported as HO-CDI, 2174 (40.2%) were CO-CDI, and 339 (6.3%) had onset of symptoms in another healthcare facility (eg, nursing home). The proportion of CO-CDI increased over the years and was lower during winter months. Hospitalized patients with CO-CDI were younger (63.8 vs 68.0 years, P < .001) and more often females (53.0% vs 49.6%, P = .02) than patients with HO-CDI. Median time between onset of symptoms and CDI testing was longer in CO-CDI (4 vs 1 day, P < .001). Similar ribotypes were found in CO-CDI and HO-CDI, but ribotype 001 was more frequent among HO-CDI, whereas ribotype 023 was more frequent in CO-CDI. Six of 7 (85.7%) surgeries due to CDI, 27 of 50 (54%) ICU admissions due to CDI, and 48 of 107 (44.9%) of CDI-associated deaths were attributable to CO-CDI.ConclusionsOur study demonstrates that patients hospitalized with CO-CDI contribute substantially to the total number of CDI episodes and CDI-associated complications in hospitals, stressing the need for awareness and early testing for CDI in community and outpatient settings and also in patients admitted from community with diarrhoea. Surveillance programs that also target nonhospitalized CDI patients are needed to understand the true burden and dynamics of CDI.

show abstract

Section: Discussionmentioning

confidence: 99%

Community-Onset Clostridioides Difficile Infection in Hospitalized Patients in The Netherlands

Crobach

Notermans

Harmanus

et al. 2019

Open Forum Infectious Diseases

View full text Add to dashboard Cite

show abstract

Incidence, Risk Factors, and Outcomes of Clostridium difficile Infections in Kidney Transplant Recipients

Trac

Husain

et al. 2018

Transplantation

View full text Add to dashboard Cite

show abstract

The epidemiology of Clostridium difficile infection in a national kidney transplant center

Abstract: Education regarding CDI must be extended to transplant recipients and their general practitioners. Other targets for future CDI rate reduction must include stringent antimicrobial stewardship (both in hospital and in the community) and judicious PPI prescribing.

Cited by 2 publications

References 28 publications

Community-Onset Clostridioides Difficile Infection in Hospitalized Patients in The Netherlands

Community-Onset Clostridioides Difficile Infection in Hospitalized Patients in The Netherlands

Incidence, Risk Factors, and Outcomes of Clostridium difficile Infections in Kidney Transplant Recipients

Contact Info

Product

Resources

About