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"Clostridium difficile" "prevention"

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https://www.readbyqxmd.com/read/29352824/evaluating-the-effect-of-a-clostridium-difficile-infection-prevention-initiative-in-veterans-health-administration-long-term-care-facilities
#1
Maninder B Singh, Martin E Evans, Loretta A Simbartl, Stephen M Kralovic, Gary A Roselle
We evaluated rates of clinically confirmed long-term-care facility-onset Clostridium difficile infections from April 2014 through December 2016 in 132 Veterans Affairs facilities after the implementation of a prevention initiative. The quarterly pooled rate decreased 36.1% from the baseline (P<.0009 for trend) by the end of the analysis period. Infect Control Hosp Epidemiol 2018;1-3.
January 21, 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29336928/tackling-the-recurrence-of-clostridium-difficile-infection
#2
REVIEW
N Petrosillo
The pathogenesis of recurrent Clostridium difficile infection (CDI) is still poorly understood. The risk of recurrence is approximately 20% after an initial CDI episode and dramatically increases with subsequent CDI recurrences. Several factors may play a role in recurrent CDI (rCDI), including conditions influencing germination, metabolic pathways that influence toxin production of C. difficile, and the microbiota composition offering protection against colonization and disease caused by C. difficile. Paradoxically, the currently recommended treatment for acute symptomatic CDI, i...
January 11, 2018: Médecine et Maladies Infectieuses
https://www.readbyqxmd.com/read/29331160/reduction-in-rate-of-nosocomial-respiratory-virus-infections-in-a-children-s-hospital-associated-with-enhanced-isolation-precautions
#3
Lorry G Rubin, Nina Kohn, Susan Nullet, Margaret Hill
OBJECTIVE To determine whether the use of enhanced isolation precautions (droplet and contact precautions) for inpatients with respiratory tract viral infections is associated with a reduction in rate of nosocomial viral respiratory infections. DESIGN Quasi-experimental study with the rate of nosocomial respiratory virus infection as the primary dependent variable and rate of nosocomial Clostridium difficile infection as a nonequivalent dependent variable comparator. SETTING Cohen Children's Medical Center of NY, a tertiary-care children's hospital attached to a large general hospital...
January 14, 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29323607/efficacy-of-oral-vancomycin-in-primary-prevention-of-clostridium-difficile-infection-in-elderly-patients-treated-with-systemic-antibiotic-therapy
#4
Neven Papic, Lorna Stemberger Maric, Adriana Vince
No abstract text is available yet for this article.
January 11, 2018: Infectious Diseases
https://www.readbyqxmd.com/read/29322624/nasogastric-tube-and-outcomes-of-clostridium-difficile-infection-a-systematic-review-and-meta-analysis
#5
Karn Wijarnpreecha, Suthanya Sornprom, Charat Thongprayoon, Parkpoom Phatharacharukul, Wisit Cheungpasitporn
AIMS: Clostridium difficile infection (CDI) is a major concern for public health worldwide. Interestingly, the risk of poor clinical outcomes of CDI in patients with nasogastric tube (NGT) insertion is still controversial. The aim of this study was to assess the outcomes of CDI in patients with NGT insertion. METHODS: A literature search was performed using MEDLINE, EMBASE, and The Cochrane Database of Systematic Reviews from inception through November 2017. Studies that reported relative risks, odds ratios, or hazard ratios comparing the clinical outcome of CDI in patients with NGT versus those who did not were included...
January 11, 2018: Journal of Evidence-based Medicine
https://www.readbyqxmd.com/read/29321041/effects-of-stress-ulcer-prophylaxis-in-adult-icu-patients-receiving-renal-replacement-therapy-sup-icu-renal-siren-study-protocol-for-a-pre-planned-observational-study
#6
Joerg C Schefold, Anders Perner, Theis Lange, Jørn Wetterslev, Matt P Wise, Mark Borthwick, Stepani Bendel, Frederik Keus, Anne Berit Guttormsen, Søren Marker, Mette Krag, Morten Hylander Møller
BACKGROUND: Proton pump inhibitors are often used in critically ill patients to prevent gastrointestinal bleeding despite limited evidence for benefit. Patients with acute kidney injury requiring renal replacement therapy (RRT) are at high risk of gastrointestinal bleeding as (pre-)uremia induces coagulopathy through effects on platelets and coagulation cascades. No high-quality randomized clinical trials have previously assessed the benefits and harms of prophylactic proton pump inhibitor use in this high-risk population of adult critically ill patients...
January 10, 2018: Trials
https://www.readbyqxmd.com/read/29317259/adherence-to-contact-precautions-among-different-types-of-healthcare-workers-through-video-monitoring-in-a-tertiary-hospital
#7
Yuichi Katanami, Kayoko Hayakawa, Takeshi Shimazaki, Yuko Sugiki, Saho Takaya, Kei Yamamoto, Satoshi Kutsuna, Yasuyuki Kato, Norio Ohmagari
BACKGROUND: Contact precautions are required to prevent transmission of multidrug-resistant organisms; however, reports on adherence rates vary. Through video monitoring, we evaluated adherence to the use of personal protective equipment (PPE) among different types of healthcare workers. METHODS: This study was an observational study conducted in a 781-bed tertiary hospital from July 2016 to March 2017. We installed cameras in areas where staff don PPE. Infection control teams observed the videos and assessed adherence rates...
January 6, 2018: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29316555/intestinal-dysbiosis-secondary-to-proton-pump-inhibitor-use
#8
Yuji Naito, Kaori Kashiwagi, Tomohisa Takagi, Akira Andoh, Ryo Inoue
BACKGROUND: Gut dysbiosis associated with the use of proton-pump inhibitors (PPIs) has been found to lead to the occurrence of infectious and inflammatory adverse events. A longitudinal observational cohort study has demonstrated the heightened risk of death associated with PPI use. SUMMARY: We evaluated meta-analyses to determine the association between PPI use and infectious and inflammatory diseases. Meta-analyses showed that PPI use is a potential risk for the development of enteric infections caused by Clostridium difficile, as well as small intestinal bacterial overgrowth, spontaneous bacterial peritonitis, community-acquired pneumonia, hepatic encephalopathy, and adverse outcomes in inflammatory bowel disease...
January 6, 2018: Digestion
https://www.readbyqxmd.com/read/29305285/national-healthcare-safety-network-laboratory-identified-clostridium-difficile-event-reporting-a-need-for-diagnostic-stewardship
#9
Clare Rock, Zoi Pana, Surbhi Leekha, Polly Trexler, Jennifer Andonian, Avinash Gadala, Karen C Carroll, Lisa L Maragakis
We describe the proportion of health care facility-onset Clostridium difficile infection (HO-CDI) National Healthcare Safety Network laboratory-identified events at our facility that were deemed nontrue HO-CDIs. Reasons included testing in a patient without significant diarrhea or with recent laxative use, or delayed testing. Standardized infection ratios using only true HO-CDI in the numerator were improved compared with publically reported standardized infection ratios. A prioritization matrix identifies which clinical services could benefit most from directed diagnostic stewardship interventions...
January 2, 2018: American Journal of Infection Control
https://www.readbyqxmd.com/read/29290480/cleaning-the-air-with-ultraviolet-germicidal-irradiation-lessened-contact-infections-in-a-long-term-acute-care-hospital
#10
Tina Ethington, Sherry Newsome, Jerri Waugh, Linda D Lee
BACKGROUND: This study was designed to determine whether removing bacteria from the air with ultraviolet germicidal irradiation (UV-C) at the room level would reduce infection rates. METHODS: We reviewed infection data for 12 months before and after UV-C installation in the special care unit (SCU) of a long-term acute care hospital. All patients admitted to the SCU during the study time frame were included. Microbiologic impactor air sampling was completed in August 2015...
December 29, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/29274463/how-to-surveillance-of-clostridium-difficile-infections
#11
REVIEW
Marcela Krutova, Pete Kinross, Frédéric Barbut, Agnes Hajdu, Mark Wilcox, Ed Kuijper
BACKGROUND: The increasing incidence of Clostridium difficile infections (CDI) in healthcare settings in Europe since 2003 has affected both patients and healthcare systems. The implementation of effective CDI surveillance is key to enable monitoring of the occurrence and spread of C. difficile in healthcare and the timely detection of outbreaks. AIMS: The aim of this review is to provide a summary of key components of effective CDI surveillance and to provide some practical recommendations...
December 20, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/29259371/probiotics-for-gastrointestinal-disorders-proposed-recommendations-for-children-of-the-asia-pacific-region
#12
REVIEW
Donald Cameron, Quak Seng Hock, Musal Kadim, Neelam Mohan, Eell Ryoo, Bhupinder Sandhu, Yuichiro Yamashiro, Chen Jie, Hans Hoekstra, Alfredo Guarino
Recommendations for probiotics are available in several regions. This paper proposes recommendations for probiotics in pediatric gastrointestinal diseases in the Asia-Pacific region. Epidemiology and clinical patterns of intestinal diseases in Asia-Pacific countries were discussed. Evidence-based recommendations and randomized controlled trials in the region were revised. Cultural aspects, health management issues and economic factors were also considered. Final recommendations were approved by applying the Likert scale and rated using the GRADE system...
December 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29237206/-piperacillin-tazobactam-shortage-central-restriction-and-alternative-recommendations-as-effective-antibiotic-stewardship-intervention-at-a-maximal-care-hospital
#13
Johanna Kessel, Barbara Dolff, Thomas Wichelhaus, Nils Keiner, Michael Hogardt, Claudia Reinheimer, Imke Wieters, Sebastian Harder, Volkhard A J Kempf, Christoph Stephan
Background Drug supply bottleneck is a worldwide challenge, e. g. the antibiotics Piperacillin/Tazobactam shortage in 2016/2017. The efficacy of an appropriate replacement management was evaluated at the University Hospital Frankfurt (UHF). Methods The Antibiotic-Stewardship (ABS)-Team at UHF decreed a restriction of PIP/TAZ and provided alternative antibiotic therapy recommendations during the shortage period. Consequences of this intervention on antibiotic consumption and overall costs were investigated...
December 13, 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29234211/bezlotoxumab-zinplava-for-clostridium-difficile-infection-the-first-monoclonal-antibody-approved-to-prevent-the-recurrence-of-a-bacterial-infection
#14
Yuman Lee, Wai I Lim, Caitlyn I Bloom, Samantha Moore, Elizabeth Chung, Nino Marzella
Bezlotoxumab (Zinplava) to prevent the recurrence of Clostridium difficile infection.
December 2017: P & T: a Peer-reviewed Journal for Formulary Management
https://www.readbyqxmd.com/read/29230429/cost-effectiveness-analysis-of-probiotic-use-to-prevent-clostridium-difficile-infection-in-hospitalized-adults-receiving-antibiotics
#15
Nicole T Shen, Jared A Leff, Yecheskel Schneider, Carl V Crawford, Anna Maw, Brian Bosworth, Matthew S Simon
Background: Systematic reviews with meta-analyses and meta-regression suggest that timely probiotic use can prevent Clostridium difficile infection (CDI) in hospitalized adults receiving antibiotics, but the cost effectiveness is unknown. We sought to evaluate the cost effectiveness of probiotic use for prevention of CDI versus no probiotic use in the United States. Methods: We programmed a decision analytic model using published literature and national databases with a 1-year time horizon...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29224205/healthcare-acquired-infections-prevention-strategies
#16
Shelanah A Fernando, Timothy J Gray, Thomas Gottlieb
Healthcare-acquired infections (HAI) impact on patient care and have cost implications for the Australian healthcare system. The management of HAI is exacerbated by rising rates of antimicrobial resistance (AMR). Health-care workers and a contaminated hospital environment are increasingly implicated in the transmission and persistence of multi-resistant organisms (MRO), as well as other pathogens, such as Clostridium difficile. This has resulted in a timely focus on a range of HAI prevention actions. Core components include antimicrobial stewardship, to reduce overuse and ensure evidence-based antimicrobial use; infection prevention strategies, to control MRO - particularly methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus spp...
December 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/29222426/surveillance-of-antibiotic-resistance-among-common-clostridium-difficile-ribotypes-in-hong-kong
#17
Viola C Y Chow, Thomas N Y Kwong, Erica W M So, Yolanda I I Ho, Sunny H Wong, Raymond W M Lai, Raphael C Y Chan
Incidence of Clostridium difficile infection (CDI) is rapidly increasing and it poses a major health burden globally. However, data regarding the epidemiology of CDI in Asia are limited. We aimed to characterize the antimicrobial susceptibility patterns of common ribotypes of toxigenic C. difficile in Hong Kong. Fifty-three PCR ribotypes were identified among 284 toxigenic C. difficile clinical isolates. The five most prevalent ribotypes were 002 (13%), 017 (12%), 014 (10%), 012 (9.2%), and 020 (9.5%). All tested C...
December 8, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29210765/environmental-infection-prevention-priorities-of-patient-safety-collaboration
#18
Patti G Grota, Patti S Grant
Although progress has been made in decreasing health care-associated infections (HAI) in intensive care unit (ICU) patients, there has been an increase in HAI caused by drug-resistant pathogens, particularly those that contaminate the environment such as methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus, Pseudomonas spp, Acinetobacter spp, and Clostridium difficile. The ICU environment including sinks and medical equipment has been identified as being at risk for contamination and associated with cross-transmission of pathogens between the health care provider, the environment, and the patient...
January 2018: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/29202142/antibiotic-overprescribing-still-a-major-concern
#19
David C Fiore, Lacy P Fettic, Stephanie D Wright, Bonnie R Ferrara
Despite universal agreement that antibiotic overprescribing is a problem, the practice continues to vex us. Antibiotic use--whether appropriate or not--has been linked to rising rates of antimicrobial resistance, disruption of the gut microbiome leading to Clostridium difficile infections, allergic reactions, and increased health care costs. And yet, physicians continue to overprescribe this class of medication. A 2016 Centers for Disease Control and Prevention report estimates that at least 30% of antibiotics prescribed in US outpatient settings are unnecessary...
December 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/29199388/efficacy-and-safety-of-stress-ulcer-prophylaxis-in-critically-ill-patients-a-network-meta-analysis-of-randomized-trials
#20
REVIEW
Waleed Alhazzani, Fayez Alshamsi, Emilie Belley-Cote, Diane Heels-Ansdell, Romina Brignardello-Petersen, Mustafa Alquraini, Anders Perner, Morten Hylander Møller, Mette Krag, Saleh Almenawer, Bram Rochwerg, Joanna Dionne, Roman Jaeschke, Mohammed Alshahrani, Adam Deane, Dan Perri, Lehana Thebane, Awad Al-Omari, Simon Finfer, Deborah Cook, Gordon Guyatt
PURPOSE: Stress ulcer prophylaxis (SUP) is commonly prescribed in the intensive care unit. However, data from systematic reviews and conventional meta-analyses are limited by imprecision and restricted to direct comparisons. We conducted a network meta-analysis of randomized clinical trials (RCTs) to examine the safety and efficacy of drugs available for SUP in critically ill patients. METHODS: We searched MEDLINE, EMBASE, and the Cochrane Library Central Register of Controlled Trials through April 2017 for randomized controlled trials that examined the efficacy and safety of proton pump inhibitors (PPIs), histamine-2 receptor antagonists (H2RAs), and sucralfate for SUP in critically ill patients...
December 4, 2017: Intensive Care Medicine
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