scholarly journals The effect of hospital-acquired infection with Clostridium difficile on length of stay in hospital

2011 ◽  
Vol 184 (1) ◽  
pp. 37-42 ◽  
Author(s):  
A. J. Forster ◽  
M. Taljaard ◽  
N. Oake ◽  
K. Wilson ◽  
V. Roth ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Length Of Stay ◽  
Hospital Acquired Infection ◽  
Hospital Acquired

scholarly journals Postoperative Burden of Hospital-Acquired Clostridium difficile Infection

2015 ◽  
Vol 36 (1) ◽  
pp. 40-46 ◽  
Author(s):  
Zaid M. Abdelsattar ◽  
Greta Krapohl ◽  
Layan Alrahmani ◽  
Mousumi Banerjee ◽  
Robert W. Krell ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clostridium Difficile ◽  
Length Of Stay ◽  
Lower Extremity ◽  
Bowel Resection ◽  
Hospital Acquired Infection ◽  
Incidence Risk ◽  
Multivariable Regression Models ◽  
Hospital Acquired ◽  
The Impact

OBJECTIVEClostridium difficile infection (CDI) is a common hospital-acquired infection. Previous reports on the incidence, risk factors, and impact of CDI on resources in the surgical population are limited. In this context, we study CDI across diverse surgical settings.METHODSWe prospectively identified patients with laboratory-confirmed postoperative CDI after 40 different general, vascular, or gynecologic surgeries at 52 academic and community hospitals between July 2012 and September 2013. We used multivariable regression models to identify CDI risk factors and to determine the impact of CDI on resource utilization.RESULTSOf 35,363 patients, 179 (0.51%) developed postoperative CDI. The highest rates of CDI occurred after lower-extremity amputation (2.6%), followed by bowel resection or repair (0.9%) and gastric or esophageal operations (0.7%). Gynecologic and endocrine operations had the lowest rates (0.1% and 0%, respectively). By multivariable analyses, older age, chronic immunosuppression, hypoalbuminemia (≤3.5 g/dL), and preoperative sepsis were associated with CDI. Use of prophylactic antibiotics was not independently associated with CDI, neither was sex, body mass index (BMI), surgical priority, weight loss, or comorbid conditions. Three procedure groups had higher odds of postoperative CDI: lower-extremity amputations (adjusted odds ratio [aOR], 3.5; P=.03), gastric or esophageal operations (aOR, 2.1; P=.04), and bowel resection or repair (aOR, 2; P=.04). Postoperative CDI was independently associated with increased length of stay (mean, 13.7 d vs 4.5 d), emergency department presentations (18.9 vs 9.1%) and readmissions (38.9% vs 7.2%, all P<.001).CONCLUSIONSIncidence of postoperative CDI varies by surgical procedure. Postoperative CDI is also associated with higher rates of extended length of stay, emergency room presentations, and readmissions, which places a potentially preventable burden on hospital resources.Infect Control Hosp Epidemiol 2015;36(1): 40–46

The Impact of Observation Units on the Rate of Hospital-Acquired Infection

2013 ◽  
Vol 34 (12) ◽  
pp. 1318-1320
Author(s):  
Anna Dow Sheahan ◽  
Kent A. Sepkowitz
Keyword(s):  
Clostridium Difficile ◽  
Infection Rate ◽  
Infection Rates ◽  
Hospital Acquired Infection ◽  
Observation Units ◽  
Hospital Acquired ◽  
The Impact

Using Clostridium difficile as an example, we calculated the impact that reduced inpatient-day denominators resulting from implemen¬tation of hospital observation units would have on hospital-acquired infection rates. Using proposed scenarios of reduced inpatient-days, we estimated an increase in the hospital-acquired C. difficile infection rate of up to 12%.

scholarly journals Appearance of Clostridium difficile infections in health care institutions in Slovakia and in the district of martin

2018 ◽  
Vol 18 (2) ◽  
pp. 5-12
Author(s):  
M Novak ◽  
I Mazakova ◽  
V Sadlonova ◽  
T Cervenova ◽  
H. Hudeckova
Keyword(s):  
Health Care ◽  
Clostridium Difficile ◽  
Older Patients ◽  
Social Impact ◽  
Slovak Republic ◽  
Risk Groups ◽  
Hospital Acquired Infection ◽  
Health Care Institutions ◽  
Hospital Acquired ◽  
Epidemiological Information

Abstract Introduction: Decrease of nonspecific imunity in patients and the treatment with broad spectrum antibiotics form appropriate conditions for the appearance of medically severe Clostridium difficile infection (CDI) - enterocolitis that can have the characteristics of community or hospital acquired infection (HAI). The aim of our work is to identify the trend of their incidence in Slovakia and to define the risk groups according to age and department of hospitalisation. Material and Methods: Retrospective analysis and comparison of the appearance of CDI was performed within the groups of patients hospitalised in health care institutions in the SR and those in the district of Martin during the period of years 2010 to 2017. The data of reported cases were taken from the Epidemiological information system of the Slovak Republic (EPIS SR), the source of demografic data was the National Center of Health Information. Resuts: Analysis shows an important increase of incidence of CDI during years 2010 to 2017. Diseases had predominantly health care associated – nosocomial – character targeting mostly older patients (65+ - 24/10 000 in the Slovak Republic and 62/10,000 in the county of Martin) and less infants (7/10,000 and 11/10,000 repectively). Conclusion: The results of our analyses are consistent with literature data about CDI enterocolitis and show their serious health and social impact in our society.

Community-acquired Clostridium difficile infection and Australian food animals

2015 ◽  
Vol 36 (3) ◽  
pp. 111 ◽  
Author(s):  
Michele M Squire ◽  
Daniel R Knight ◽  
Thomas V Riley
Keyword(s):  
High Risk ◽  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Animal Husbandry ◽  
Gram Positive ◽  
Hospital Acquired Infection ◽  
Infectious Diarrhoea ◽  
Food Animal ◽  
Risk Practices ◽  
Hospital Acquired

Clostridium difficile is an anaerobic Gram positive spore-forming bacterium, the leading cause of infectious diarrhoea (C. difficile infection; CDI) in hospitalised humans. The assumption that CDI is primarily a hospital-acquired infection is being questioned. Community-acquired CDI (CA-CDI) is increasing1 particularly in groups previously considered at low risk2,3. In Australia, CA-CDI rates doubled during 2011 and increased by 24% between 2011 and 20124. Two potentially high-risk practices in Australian food animal husbandry may present a risk for CA-CDI: slaughtering of neonatal animals for food, and effluent recycling to agriculture.

scholarly journals Contribution of Spores to the Ability of Clostridium difficile To Adhere to Surfaces

2012 ◽  
Vol 78 (21) ◽  
pp. 7671-7679 ◽  
Author(s):  
Lovleen Tina Joshi ◽  
Daniel S. Phillips ◽  
Catrin F. Williams ◽  
Abdullah Alyousef ◽  
Les Baillie
Keyword(s):  
Stainless Steel ◽  
Clostridium Difficile ◽  
Culture Media ◽  
Bacterial Species ◽  
Disease Process ◽  
Brain Heart Infusion ◽  
Content Type ◽  
Hospital Acquired Infection ◽  
The United Kingdom ◽  
Hospital Acquired

ABSTRACTClostridium difficileis the commonest cause of hospital-acquired infection in the United Kingdom. We characterized the abilities of 21 clinical isolates to form spores; to adhere to inorganic and organic surfaces, including stainless steel and human adenocarcinoma cells; and to germinate. The composition of culture media had a significant effect on spore formation, as significantly more spores were produced in brain heart infusion broth (Student'sttest;P= 0.018). The spore surface relative hydrophobicity (RH) varied markedly (14 to 77%) and was correlated with the ability to adhere to stainless steel. We observed no correlation between the ribotype and the ability to adhere to steel. When the binding of hydrophobic (DS1813; ribotype 027; RH, 77%) and hydrophilic (DS1748; ribotype 002; RH, 14%) spores to human gut epithelial cells at different stages of cell development was examined, DS1813 spores adhered more strongly, suggesting the presence of surface properties that aid attachment to human cells. Electron microscopy studies revealed the presence of an exosporium surrounding DS1813 spores that was absent from spores of DS1748. Finally, the ability of spores to germinate was found to be strain and medium dependent. While the significance of these findings to the disease process has yet to be determined, this study has highlighted the importance of analyzing multiple isolates when attempting to characterize the behavior of a bacterial species.

Epidemiology, antimicrobial resistance, and incremental medical costs of hospital-acquired infections in the Intensive Care Unit: 2-year experience from Serbia

2019 ◽  
Author(s):  
Aleksa Jovan Despotovic ◽  
Branko Milosevic ◽  
Ivana Milosevic ◽  
Andja Cirkovic ◽  
Snezana D Jovanovic ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care ◽  
Antimicrobial Resistance ◽  
Length Of Stay ◽  
Fold Increase ◽  
Antimicrobial Treatment ◽  
Hospital Acquired Infection ◽  
Hospital Acquired Infections ◽  
Resistance Rates ◽  
Hospital Acquired

Abstract Background: Hospital-acquired infections are a major complication of hospital treatment. The growing presence of multidrug-resistant pathogens contributes to increased mortality and costs, particularly in intensive care units where patients are predisposed to numerous risk factors. Comprehensive data about hospital-acquired infections from Serbian intensive care units is scarce. The aim of this study was to determine the presence of hospital-acquired infections among intensive care unit patients and look into the patterns of antimicrobial resistance, risk factors, and incremental costs of diagnosis and antimicrobial treatment. Methods: This retrospective study included 355 patients over a two-year period. Etiology, antimicrobial resistance patterns, and incremental costs of diagnosis and antimicrobial treatment were examined. Risk factors for infection acquisition, as well as length of stay, were statistically analyzed using Pearson’s chi-square tests and logistic regression analysis. Results: At least one hospital-acquired infection was identified in 32.7% of patients. A total of 204 infection episodes were documented, the most common type being urinary tract infections (36.3%). Clostridium difficile , Klebsiella spp. , and Acinetobacter baumanii were the most common isolates. Antimicrobial resistance rates < 20% were observed for linezolid (0%), colistin (9%), and tigecycline (14%). Resistance rates > 50% were seen in all other tested antibiotic agents. Mortality rates were not higher in patients who acquired only one hospital-acquired infection (p=0.09), but were significantly higher for patients in whom more than one episode occurred (p=0.038). Length of stay > 20 days carried a 7.5-fold increase in odds of acquiring an infection (CI 4.4-12.7, p<0.001), whereas length of stay > 30 days carried a 10-fold increase (CI 5.5-16.1, p<0.001). During the study period, over 37,000 EUR was incrementally spent on diagnosis and antimicrobial treatment for hospital-acquired infections. Conclusion: Our results suggest a high prevalence of hospital-acquired infections and very high antimicrobial resistance rates compared to most European countries. Together with the first published results regarding incremental costs from Serbia, our observations require large-scale prospective follow-up studies in order to obtain a deeper insight into the actual burden of hospital-acquired infections.

scholarly journals Protection from Clostridium difficile Infection in CD4 T Cell- and Polymeric Immunoglobulin Receptor-Deficient Mice

2013 ◽  
Vol 82 (2) ◽  
pp. 522-531 ◽  
Author(s):  
Pehga F. Johnston ◽  
Dale N. Gerding ◽  
Katherine L. Knight
Keyword(s):  
Clostridium Difficile ◽  
Protective Immunity ◽  
Content Type ◽  
Immunoglobulin Receptor ◽  
Hospital Acquired Infection ◽  
Histocompatibility Complex ◽  
Serum Iga ◽  
Life Threatening ◽  
Primary Hospital ◽  
Hospital Acquired

ABSTRACTClostridium difficilerivals methicillin-resistantStaphylococcus aureusas the primary hospital-acquired infection.C. difficileinfection (CDI) caused by toxins A and/or B can manifest as mild diarrhea to life-threatening pseudomembranous colitis. Although most patients recover fully from CDI, ∼20% undergo recurrent disease. Several studies have demonstrated a correlation between anti-toxin antibody (Ab) and decreased recurrence; however, the contributions of the systemic and mucosal Ab responses remain unclear. Our goal was to use the CDI mouse model to characterize the protective immune response toC. difficile. C57BL/6 mice infected with epidemicC. difficilestrain BI17 developed protective immunity against CDI and did not develop CDI upon rechallenge; they generated systemic IgG and IgA as well as mucosal IgA Ab to toxin. To determine if protective immunity toC. difficilecould be generated in immunodeficient individuals, we infectedCD4−/−mice and found that they generated both mucosal and serum IgA anti-toxin Abs and were protected from CDI upon rechallenge, with protection dependent on major histocompatibility complex class II (MHCII) expression; no IgG anti-toxin Ab was found. We found that protection was likely due to neutralizing mucosal IgA Ab. In contrast,pIgR−/−mice, which lack the receptor to transcytose polymeric Ab across the epithelium, were also protected from CDI, suggesting that although mucosal anti-toxin Ab may contribute to protection, it is not required. We conclude that protection from CDI can occur by several mechanisms and that the mechanism of protection is determined by the state of immunocompetence of the host.

scholarly journals Toxin A-producing Clostridium difficile as an aetiological factor of post-traumatic wound infection

2009 ◽  
Vol 58 (7) ◽  
pp. 963-964 ◽  
Author(s):  
Aleksander Deptuła ◽  
Ewa Kruszyńska ◽  
Agnieszka Mikucka ◽  
Eugenia Gospodarek ◽  
Krzysztof Olszewski ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Wound Infection ◽  
Aetiological Factor ◽  
Hospital Acquired Infection ◽  
Accident Victim ◽  
Amoxicillin Clavulanic Acid ◽  
Traumatic Wound ◽  
Post Traumatic ◽  
Car Accident ◽  
Hospital Acquired

Clostridium difficile is a well-known cause of hospital-acquired infection such as antibiotic associated diarrhoea or pseudomembranous colitis. Extraintestinal infections caused by this pathogen are described rarely. A case of post-traumatic wound infection caused by C. difficile in an immunocompetent, young and otherwise healthy trauma patient is reported. A 31-year-old female, a car accident victim, was admitted to hospital because of polytrauma. After open reduction and internal fixation of a supracondylar femoral fracture by means of the dynamic condylar screw (DCS) system, a purulent fistula occurred. Microbiological examination of the pus revealed C. difficile as the single aetiological factor of this infection. Empirical antibiotic treatment with cefazoline and metronidazole had been administered right after the surgery, but was found to be ineffective. The strain isolated from the patient was sensitive to most antimicrobials except for clindamycin, and amoxicillin/clavulanic acid was chosen for the guided therapy. Such treatment combined with the removal of the DCS system produced a desirable effect.

Sign in / Sign up

Export Citation Format

Share Document