Skin and Environmental Contamination in Patients Diagnosed With Clostridium difficile Infection but Not Meeting Clinical Criteria for Testing

2015 ◽  
Vol 36 (11) ◽  
pp. 1348-1350 ◽  
Author(s):  
Sirisha Kundrapu ◽  
Venkata Sunkesula ◽  
Myreen Tomas ◽  
Curtis J. Donskey
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Environmental Contamination ◽  
Infect Control Hosp ◽  
Antibiotic Exposure ◽  
Clinical Criteria

Of 134 patients diagnosed with Clostridium difficile infection, 30 (22%) did not meet clinical criteria for testing because they lacked significant diarrhea or had alternative explanations for diarrhea and no recent antibiotic exposure. For these patients, skin and/or environmental contamination was common only in those with prior antibiotic exposure.Infect. Control Hosp. Epidemiol. 2015;36(11):1348–1350

scholarly journals Probiotics to Reduce Clostridium difficile Infection: Clinical Experience in a Tertiary Care Center

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S384-S384
Author(s):  
Maggie Box ◽  
Kristine Ortwine ◽  
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Primary Outcome ◽  
Care Center ◽  
Tertiary Care ◽  
Concomitant Administration ◽  
Antibiotic Exposure ◽  
Time Period ◽  
Probiotic Preparation ◽  
Hospital Acquired

Abstract Background There is conflicting clinical data regarding the efficacy of probiotics to prevent Clostridium difficile infection (CDI). The goal of this study is to compare rates of hospital acquired Clostridium difficile infection (HA-CDI) among patients receiving antibiotics with or without concomitant administration of probiotics. Methods This retrospective, cohort study compares hospitalized patients who received antibiotics alone vs. antibiotics plus a multi-strain probiotic preparation of lactobacillus over a six month time period. Probiotics were given at the discretion of the physician. The primary outcome was incidence in HA-CDI (defined as onset after hospital day three) between groups. Results A total of 1,576 patients met selection criteria, with 927 patients receiving antibiotics alone and 649 patients receiving antibiotics plus probiotics. HA-CDI rates were 0.9% and 1.8% (P = 0.16), respectively. In a subgroup analysis of patients in the antibiotic only group, patients who received similar antibiotic exposure as the probiotics group (n = 284) had no difference in rates of HA-CDI (1.8% vs. 1.8%; P = 1.0). Conclusion Probiotic administration did not decrease rates of HA-CDI in our institution. We recommend prioritizing resources to other CDI reduction measures such as decreasing antibiotic exposure and preventing transmission. Disclosures All authors: No reported disclosures.

Lack of Benefit With Combination Therapy for Clostridium difficile Infection

2017 ◽  
Vol 38 (5) ◽  
pp. 602-605
Author(s):  
Jessica C. Njoku ◽  
Trevor C. Van Schooneveld ◽  
Mark E. Rupp ◽  
Keith M. Olsen ◽  
Fang Qiu ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Combination Therapy ◽  
Confidence Interval ◽  
Clinical Outcomes ◽  
Clostridium Difficile Infection ◽  
Infect Control Hosp ◽  
Limited Data ◽  
Duration Of Therapy ◽  
Prolonged Duration

Limited data exist regarding combination therapy for Clostridium difficile infection (CDI). After adjusting for confounders in a cohort of patients with CDI and≥1 year old, combination therapy was not associated with significant differences in clinical outcomes, but it was associated with prolonged duration of therapy (1.22 days; 95% confidence interval, 1.03–1.44 days; P=.02).Infect Control Hosp Epidemiol 2017;38:602–605

Electronic Clostridium difficile Infection Bundle Reduces Time to Initiation of Contact Precautions

2016 ◽  
Vol 38 (2) ◽  
pp. 242-244 ◽  
Author(s):  
Courtney M. Dewart ◽  
Natalia Blanco ◽  
Betsy Foxman ◽  
Anurag N. Malani
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Infect Control Hosp ◽  
Contact Precaution ◽  
Order Entry ◽  
Contact Precautions ◽  
Computerized Order Entry ◽  
Time To Initiation ◽  
The Impact ◽  
Reduced Time

The impact of computerized order-entry bundles on timing of contact precaution initiation for C. difficile infection (CDI) remains largely unexplored. Implementation of an electronic CDI prevention and management bundle that included an automatic isolation component significantly reduced time to initiation of contact precautions from 33.7 to 22.4 hours.Infect Control Hosp Epidemiol 2016;242–244

scholarly journals Clostridium Difficile Infection in the United States: A National Study Assessing Preventive Practices Used and Perceptions of Practice Evidence

2015 ◽  
Vol 36 (8) ◽  
pp. 969-971 ◽  
Author(s):  
Sanjay Saint ◽  
Karen E. Fowler ◽  
Sarah L. Krein ◽  
David Ratz ◽  
Scott A. Flanders ◽  
...  
Keyword(s):  
United States ◽  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Antimicrobial Stewardship ◽  
The United States ◽  
Infect Control Hosp ◽  
National Study ◽  
Strength Of Evidence ◽  
Preventive Practices ◽  
Evidence Strength

We surveyed 571 US hospitals about practices used to prevent Clostridium difficile infection (CDI). Most hospitals reported regularly using key CDI prevention practices, and perceived their strength of evidence as high. The largest discrepancy between regular use and perceived evidence strength occurred with antimicrobial stewardship programs.Infect. Control Hosp. Epidemiol. 2015;36(8):969–971

scholarly journals 2236. Stool-Derived Inflammatory Mediators Serve as Biomarkers of Severity in Clostridium difficile Infection

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S764-S765
Author(s):  
Jonathan Motyka ◽  
Aline Penkevich ◽  
D Alex Perry ◽  
Shayna Weiner ◽  
Alexandra Standke ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Inflammatory Mediators ◽  
Characteristic Curve ◽  
Severe Disease ◽  
Receiver Operator Characteristic Curve ◽  
Health Concern ◽  
Clinical Microbiology Laboratory ◽  
Clinical Criteria ◽  
Clinical Covariates

Abstract Background Clostridium difficile infection (CDI) is a major public health concern and frequently results in severe disease, including death. Predicting subsequent complications early in the course can help optimize treatments and improve outcomes. However, models based on clinical criteria alone are not accurate and/or do not validate. We hypothesized that inflammatory mediators from the stool would be biomarkers for severity and complications. Methods Subjects were included after testing positive for toxigenic C. difficile by the clinical microbiology laboratory via enzyme immunoassay (EIA) for glutamate dehydrogenase and toxins A/B, with reflex to tcdB gene PCR for discordants. Stool was thawed on ice, diluted 1:1 with PBS and protease inhibitor, centrifuged, and the supernatant was analyzed by a custom antibody-linked bead array with 17 inflammatory mediators. Measurements were normalized and log-transformed. IDSA severity was defined by serum white blood cell count > 15000 cells/µL or creatinine 1.5-fold above baseline. Primary 30-day outcomes were all-cause mortality and attributable disease-related complications (DRC): ICU admission, colectomy, and/or death. Analyses included principal components, permutational multivariate ANOVA (PERMANOVA), and logistic regression ± L1 regularization and 5-fold cross validation. The area under the receiver operator characteristic curve (AuROC) was computed. Results We included 225 subjects, with 124 females (55.1%), average age 58.5 (±17), and more PCR+ than toxin EIA+ (170 vs. 55, respectively). IDSA severity, death, and DRCs occurred in 79 (35.1%), 14 (6.2%), and 12 (5.3%) subjects, respectively. PCA and PERMANOVA showed IDSA severity (P = 0.009) but not death or DRCs associated with the panel (figure). Several inflammatory mediators associated with IDSA severity and death (table). Machine learning models had AuROCs of 0.77 (IDSA severity), 0.84 (death), and 0.7 (DRCs). Conclusion We found that specific inflammatory mediators from the stool of patients with CDI associate with severity and complications. These results are promising, but need replication in a larger dataset and should be incorporated into models that include clinical covariates prior to deployment. Disclosures All authors: No reported disclosures.

scholarly journals Role of Coinfecting Strains in Recurrent Clostridium difficile Infection

2016 ◽  
Vol 37 (12) ◽  
pp. 1481-1484 ◽  
Author(s):  
Janet Sun ◽  
Tracy Mc Millen ◽  
N. Esther Babady ◽  
Mini Kamboj
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Mixed Infection ◽  
Single Case ◽  
Infect Control Hosp ◽  
Toxigenic Strain ◽  
Recurrent Clostridium Difficile Infection

The contribution of mixed infection in recurrent Clostridium difficile infection (CDI) episodes is not known. Among paired isolates from 52 patients, mixed infection due to >1 toxigenic strain of C. difficile was identified in 8% of first episodes. Among recurrences, relapse from 1 or both co-infecting strains was uncommon; it was detected in a single case each.Infect Control Hosp Epidemiol 2016;1481–1484

Sign in / Sign up

Export Citation Format

Share Document