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Clostridium difficile AND antimicrobial stewardship

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https://www.readbyqxmd.com/read/29075130/national-antimicrobial-stewardship-and-fluoroquinolone-resistant-clostridium-difficile-in-china
#1
Meng Xiao, Jing-Wei Cheng, Timothy Kudinha, Fanrong Kong, Ying-Chun Xu
No abstract text is available yet for this article.
2017: Infection and Drug Resistance
https://www.readbyqxmd.com/read/28980505/clostridium-difficile-infection-new-approaches-to-prevention-non-antimicrobial-treatment-and-stewardship
#2
Maria Adriana Cataldo, Guido Granata, Nicola Petrosillo
Despite the large amount of scientific publications exploring the epidemiology and the clinical management of Clostridium difficile (CD) infection, some issues remain unsolved or need further studies. The aim of this review is to give an update on the hot topics on CD prevention, including stewardship programs, and on the non-microbiological treatment of CD infection. Areas covered: This article will review the importance of minimizing the CD spore shedding in the healthcare environment for potentially reducing CD transmission...
October 9, 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28958443/interhospital-patient-transfers-between-ontario-s-academic-and-large-community-hospitals-increase-the-risk-of-clostridium-difficile-infection
#3
Giulio DiDiodato, Leslie McArthur
BACKGROUND: The objective of this study is to determine the impact of interhospital patient transfers on the risk of Clostridium difficile infection (CDI). METHODS: The number of interhospital patient transfers and CDI cases for 11 academic and 40 large community hospitals (LCHs) were available from 2010-2015. These data were used to compute a CDI score for each sending facility as a measure of CDI pressure on the receiving facility. This CDI score was included as a variable in a multilevel mixed-effect Poisson regression model of CDI cases...
September 25, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28943204/considerations-for-antibiotic-prophylaxis-in-head-and-neck-cancer-surgery
#4
Michael P Veve, Susan L Davis, Amy M Williams, John E McKinnon, Tamer A Ghanem
Peri/post-operative antibiotic prophylaxis (POABP) has become standard practice for preventing surgical site infections (SSI) in head and neck cancer patients undergoing microvascular reconstruction, but few data exist on optimal POABP regimens. Current surgical prophylaxis guideline recommendations fail to account for the complexity of microvascular reconstruction relative to other head and neck procedures, specifically regarding wound classification and antibiotic duration. Selection of POABP spectrum is also controversial, and must balance the choice between too narrow, risking subsequent infection, or too broad, and possible unwanted effects (e...
November 2017: Oral Oncology
https://www.readbyqxmd.com/read/28856589/impact-of-a-mixed-educational-and-semi-restrictive-antimicrobial-stewardship-project-in-a-large-teaching-hospital-in-northern-italy
#5
Daniele Roberto Giacobbe, Valerio Del Bono, Malgorzata Mikulska, Giulia Gustinetti, Anna Marchese, Federica Mina, Alessio Signori, Andrea Orsi, Fulvio Rudello, Cristiano Alicino, Beatrice Bonalumi, Alessandra Morando, Giancarlo Icardi, Sabrina Beltramini, Claudio Viscoli
BACKGROUND: The overuse of antimicrobials favors the dissemination of antimicrobial resistance, as well as invasive fungal diseases and Clostridium difficile infections (CDI). In this study, we assessed the impact of a mixed educational and semi-restrictive antimicrobial stewardship (AMS) project in a large teaching hospital in Italy. METHODS: The AMS project was conducted from May 2014 to April 2016. It consisted of two initiatives in two consecutive periods: (1) educational activities; (2) semi-restrictive control of antimicrobial prescribing through a computerized software...
August 30, 2017: Infection
https://www.readbyqxmd.com/read/28757087/associations-between-antimicrobial-stewardship-program-elements-and-clostridium-difficile-infection-performance
#6
Giulia Barlow, Julie Patterson, Jeremy Stultz, Amy L Pakyz
Hospitals are categorized as better, no different, or worse at a national level based on their Clostridium difficile infection performance. Institutional antimicrobial stewardship programs seek to decrease the occurrence of C difficile by implementing strategies to address antibiotic usage; however, optimal structure and strategies for accomplishing this remain largely unknown. We found that a higher proportion of hospitals with either a worse or no different rank used a postprescription audit and feedback strategy than hospitals with a better rank...
July 27, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28750918/susceptibilities-of-clinical-clostridium-difficile-isolates-to-antimicrobials-a-systematic-review-and-meta-analysis-of-studies-since-1970
#7
REVIEW
N Khanafer, N Daneman, T Greene, A Simor, P Vanhems, M Samore, K A Brown
OBJECTIVES: Although exposure to antibiotics can cause Clostridium difficile infection, certain antibiotics are used to treat C. difficile. Measurements of antimicrobial C. difficile activity could help to identify antibiotic risk and emergent resistance. Here, we describe publication patterns relating to C. difficile susceptibilities and estimate minimum inhibitory concentrations (MIC) for antibiotic classes in the published literature between January 1970 and June 2014. METHODS: We queried PUBMED and EMBASE for studies reporting antibiotic C...
July 24, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28622340/antibiotic-prophylaxis-for-surgical-site-infections-as-a-risk-factor-for-infection-with-clostridium-difficile
#8
Aubrey Balch, Aaron M Wendelboe, Sara K Vesely, Dale W Bratzler
OBJECTIVE: We aimed to measure the association between 2013 guideline concordant prophylactic antibiotic use prior to surgery and infection with Clostridium difficile. DESIGN: We conducted a retrospective case-control study by selecting patients who underwent a surgical procedure between January 1, 2012 and December 31, 2013. SETTING: Large urban community hospital. PATIENTS: Cases and controls were patients age 18+ years who underwent an eligible surgery (i...
2017: PloS One
https://www.readbyqxmd.com/read/28614043/antibiotics-vs-appendectomy-for-acute-uncomplicated-appendicitis-in-adults-review-of-the-evidence-and-future-directions
#9
REVIEW
Jared M Huston, Lillian S Kao, Phillip K Chang, James M Sanders, Sara Buckman, Charles A Adams, Christine S Cocanour, Sarah E Parli, Julia Grabowski, Jose Diaz, Jeffrey M Tessier, Therese M Duane
BACKGROUND: Acute appendicitis is the most common abdominal surgical emergency in the United States, with a lifetime risk of 7%-8%. The treatment paradigm for complicated appendicitis has evolved over the past decade, and many cases now are managed by broad-spectrum antibiotics. We determined the role of non-operative and operative management in adult patients with uncomplicated appendicitis. METHODS: Several meta-analyses have attempted to clarify the debate. Arguably the most influential is the Appendicitis Acuta (APPAC) Trial...
July 2017: Surgical Infections
https://www.readbyqxmd.com/read/28603609/antimicrobial-susceptibility-of-clostridium-difficile-isolated-in-thailand
#10
Papanin Putsathit, Monthira Maneerattanaporn, Pipat Piewngam, Daniel R Knight, Pattarachai Kiratisin, Thomas V Riley
BACKGROUND: Exposure to antimicrobials is the major risk factor associated with Clostridium difficile infection (CDI). Paradoxically, treatment of CDI with antimicrobials remains the preferred option. To date, only three studies have investigated the antimicrobial susceptibility of C. difficile from Thailand, two of which were published in the 1990s. This study aimed to investigate the contemporary antibiotic susceptibility of C. difficile isolated from patients in Thailand. METHODS: A collection of 105 C...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/28542111/clostridium-difficile-infection-in-solid-organ-transplant-recipients
#11
Deepa Nanayakkara, Neha Nanda
PURPOSE OF REVIEW: Clostridium difficile infection (CDI) is a major healthcare-associated infection that causes significant morbidity and an economic impact in the United States. In this review, we provide an overview of Clostridium difficile infection in solid organ transplant recipients with an emphasis on recent literature. RECENT FINDINGS: C. difficile in solid organ transplant population has unique risk factors. Fecal microbiota transplantation has shown favorable results in treatment of recurrent C...
August 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28538249/norovirus-and-clostridium-difficile-outbreaks-squelching-the-wildfire
#12
Ann Fisher, Louise M Dembry
PURPOSE OF REVIEW: Gastrointestinal outbreaks in the healthcare setting cause increased morbidity and mortality in an already vulnerable population. Optimization of infection prevention measures can be a challenge in healthcare settings. This review describes new literature that may change the traditional infection prevention approach to such outbreaks. RECENT FINDINGS: Asymptomatic carriers of both norovirus and Clostridium difficile can pose risk of transmission to others and the environment...
August 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28526311/dramatic-effects-of-a-new-antimicrobial-stewardship-program-in-a-rural-community-hospital
#13
Claudia R Libertin, Stephanie H Watson, William L Tillett, Joy H Peterson
BACKGROUND: New Joint Commission antimicrobial stewardship requirements took effect on January 1, 2017, promoted as a central strategy for coping with the emerging problems of antimicrobial resistance and Clostridium difficile infection. Our objective was to measure the effects of a new antimicrobial stewardship program (ASP) in a rural community hospital with no prior ASP, in the context of having a new infectious disease specialist on staff. METHODS: An ASP team was formed to implement a prospective audit with health care provider feedback and targeting 12 antimicrobial agents in a rural hospital in Georgia...
September 1, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28526309/antimicrobial-stewardship-for-hospitalized-patients-with-viral-respiratory-tract-infections
#14
Christopher F Lowe, Michael Payne, David Puddicombe, Allison Mah, Davie Wong, Allison Kirkwood, Mark W Hull, Victor Leung
BACKGROUND: The purpose of this study was to implement a targeted antimicrobial stewardship intervention for patients with a viral respiratory tract infection. METHODS: This was a quasi-experimental before and after audit and feedback intervention of adult inpatients with a positive polymerase chain reaction for a respiratory virus in 2 acute care hospitals in Vancouver, Canada. Audit and feedback was implemented based on 2 criteria: microbiology (no positive bacterial cultures) and chest imaging (absence of pneumonia or consolidation on radiology dictation)...
May 16, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28480242/outcomes-associated-with-antimicrobial-de-escalation-of-treatment-for-pneumonia-within-the-veterans-healthcare-administration
#15
Jefferson G Bohan, Richard Remington, Makoto Jones, Matthew Samore, Karl Madaras-Kelly
De-escalation, an antimicrobial stewardship concept, involves narrowing broad-spectrum empiric antimicrobial therapy based on clinical data. Current health outcomes evidence is lacking to support de-escalation. Studying Veterans Healthcare Administration pneumonia patients, de-escalation was associated with improved length of stay without affecting 30-day readmission or 30-day Clostridium difficile infection rates.
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28476493/promoting-appropriate-urine-culture-management-to-improve-health-care-outcomes-and-the-accuracy-of-catheter-associated-urinary-tract-infections
#16
REVIEW
Robert Garcia, Eric D Spitzer
Published literature indicates that the unjustified ordering or improper collection of urine for urinalysis or culture from either catheterized patients or those without indwelling devices, or misinterpretation of positive results, often leads to adverse health care events, including increased financial burdens, overreporting of mandated catheter-associated urinary tract infection events, overtreatment of patients with antimicrobial agents, selection of multidrug-resistant organisms, and Clostridium difficile infection...
October 1, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28444166/the-effect-of-a-piperacillin-tazobactam-shortage-on-antimicrobial-prescribing-and-clostridium-difficile-risk-in-88-us-medical-centers
#17
Alan E Gross, Richard S Johannes, Vikas Gupta, Ying P Tabak, Arjun Srinivasan, Susan C Bleasdale
Background: Anti-infective shortages are a pervasive problem in the United States. The objective of this study was to identify any associations between changes in prescribing of antibiotics that have a high risk for CDI during a piperacillin/tazobactam (PIP/TAZO) shortage and hospital-onset Clostridium difficile infection (HO-CDI) risk in 88 US medical centers. Methods: We analyzed electronically captured microbiology and antibiotic use data from a network of US hospitals from July 2014 through June 2016...
August 15, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28399946/impact-of-a-multifaceted-antimicrobial-stewardship-program-a-front-line-ownership-driven-quality-improvement-project-in-a-large-urban-emergency-department
#18
Adam Jonathan Kaufman, Janine McCready, Jeff Powis
BACKGROUND: Antibiotic overuse has promoted growing rates of antimicrobial resistance and secondary antibiotic-associated infections such as Clostridium difficile (C. difficile). Antimicrobial stewardship programs (ASPs) are effective in reducing antimicrobial use in the inpatient setting; however, the unique environment of the emergency department (ED) lends itself to challenges for successful implementation. Front-line ownership (FLO) methodology has been shown to be a potentially effective strategy for the implementation of inpatient ASPs through an iterative multi-pronged approach driven by front-line providers...
April 12, 2017: CJEM
https://www.readbyqxmd.com/read/28371928/does-electronic-stewardship-work
#19
Barbara B Lambl, Nathan Kaufman, Janice Kurowski, W O'Neill, Frederick Buckley, Maureen Duram, Barbara Swartz, Duncan Phillips, Mitchell Rein, Marc Rubin
Faced with national requirements to promote antimicrobial stewardship and reduce drug-resistant infections, community hospitals are challenged to make the best use of existing resources. Eighteen months after building antibiotic decision support into our electronic order platform, high-risk antibiotic use decreased by 83% (P < .001) at our community hospital. Hospital-acquired Clostridium difficile infections declined 24% (P = .07).
September 1, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28348151/effect-of-a-health-care-system-respiratory-fluoroquinolone-restriction-program-to-alter-utilization-and-impact-rates-of-clostridium-difficile-infection
#20
Katherine M Shea, Athena L V Hobbs, Theresa C Jaso, Jack D Bissett, Christopher M Cruz, Elizabeth T Douglass, Kevin W Garey
Fluoroquinolones are one of the most commonly prescribed antibiotic classes in the United States despite their association with adverse consequences, including Clostridium difficile infection (CDI). We sought to evaluate the impact of a health care system antimicrobial stewardship-initiated respiratory fluoroquinolone restriction program on utilization, appropriateness of quinolone-based therapy based on institutional guidelines, and CDI rates. After implementation, respiratory fluoroquinolone utilization decreased from a monthly mean and standard deviation (SD) of 41...
June 2017: Antimicrobial Agents and Chemotherapy
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