Impact of a multipronged approach to reduce the incidence of Clostridioides difficile infections in hospitalized patients.
Am J Infect Control
; 51(6): 668-674, 2023 06.
Article
en En
| MEDLINE
| ID: mdl-36075295
ABSTRACT
BACKGROUND:
Effective approaches to reduce Clostridioides difficile infections (CDI) in hospitalized patients are needed. We report data from 3 years preceding and 3 years following interventions that proved successful, with detailed analysis of all cases the first year after implementation.METHODS:
Interventions included a nursing protocol to identify cases present on admission by asking if the patient had 1 or more liquid stools in the last 24 hours, and a 2-step testing algorithm with samples positive by polymerase chain reaction (PCR) for the C. difficile toxin gene reflexing to an enzyme immunoassay (EIA) for the toxin antigen.RESULTS:
Healthcare-associated infections due to CDI fell from â¼160 in each of the preceding 3 years to <65 in each of the subsequent 3 years (P < .001), while the ratio of observed-to-expected hospital-onset cases diminished to â¼0.50 (P < .02). In the first year, 395 samples were PCR(+), but only 118 (29.9%) of these were EIA(+). 55 (46.6%) of the PCR(+)/EIA(+) samples were from hospital day 1 or 2 and classified as present on admission. The mean time from stool collection to report of PCR results was â¼7.5 hours, and the EIA took on average only 68 additional minutes to be reported.CONCLUSIONS:
The number of incident CDI cases can be dramatically decreased by implementing an admission screening question and a 2-step testing algorithm.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Toxinas Bacterianas
/
Clostridioides difficile
/
Infecciones por Clostridium
Tipo de estudio:
Incidence_studies
/
Risk_factors_studies
Límite:
Humans
Idioma:
En
Revista:
Am J Infect Control
Año:
2023
Tipo del documento:
Article