scholarly journals How National Healthcare Safety Network (NHSN) Clostridium difficile (CD) Infection (I) Criteria Changes Affected the Hospital-Acquired (HA) CDI rate at University Pittsburgh Medical Center (UPMC) and Comparison to Historic Baselines

2016 ◽  
Vol 3 (suppl_1) ◽  
Author(s):  
Carlene Muto ◽  
Amy Metzger ◽  
Ashley Querry
Keyword(s):  
Clostridium Difficile ◽  
Medical Center ◽  
National Healthcare ◽  
National Healthcare Safety Network ◽  
Hospital Acquired ◽  
Pittsburgh Medical

scholarly journals 881. Efficacy of Antibiotic Prophylaxis with Vancomycin in Cardiothoracic Surgery

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S477-S477
Author(s):  
Margaret Cooper ◽  
Jing Zhao
Keyword(s):  
Primary Outcome ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Medical Center ◽  
Surgical Site Infections ◽  
National Healthcare ◽  
National Healthcare Safety Network ◽  
High Incidence ◽  
The Difference ◽  
Gram Negative Organisms ◽  
Discernible Difference

Abstract Background Due to the high incidence of methicillin-resistant Staphylococcus aureus (MRSA) at the Detroit Medical Center, vancomycin is now routinely part of the prophylaxis regimen for cardiothoracic (CT) surgery. The study aims to compare the rate and types of surgical site infections (SSIs) when vancomycin is added to cefazolin for CT surgery compared to cefazolin alone. Methods This was a retrospective cohort study conducted at two university-affiliated hospitals. Patients who underwent CT surgery between January 2008 and August 2017 and had a readmission for SSI within 90 days of procedure were included. Patients who received cefazolin were compared to patients who received both cefazolin and vancomycin for CT surgery prophylaxis. The primary outcome was incidence of SSIs within 90 days of surgery as defined by the Centers for Disease Control and National Healthcare Safety Network. Results Out of 828 patients who underwent CT surgeries, there were 32 patients readmitted within 90 days for SSI. SSI occurred in 4.7% of patients who received cefazolin monotherapy, and 2.4% of patients who received both cefazolin and vancomycin (p=0.095). There was no discernible difference in types of SSI between groups. Pathogens were isolated in 78% of SSIs, with 75% Gram-positive and 19% Gram-negative organisms. SSIs resulted in an average 9.8 days in the hospital and 28.9 days of antibiotic therapy, and led to a total of 15 additional procedures. Conclusion Vancomycin added to cefazolin for prophylaxis in CT surgery resulted in lower incidence of SSI, however the difference was not statistically significant. Disclosures All Authors: No reported disclosures

Incidence and Risk Factors for Community and Hospital Acquisition of Clostridium difficile Infection in the Tel Aviv Sourasky Medical Center

2017 ◽  
Vol 38 (8) ◽  
pp. 912-920 ◽  
Author(s):  
Wasef Na’amnih ◽  
Amos Adler ◽  
Tamar Miller-Roll ◽  
Dani Cohen ◽  
Yehuda Carmeli
Keyword(s):  
Risk Factors ◽  
Clostridium Difficile ◽  
Confidence Interval ◽  
Family Member ◽  
Incidence Rate ◽  
Odds Ratio ◽  
Close Contact ◽  
Medical Center ◽  
Tel Aviv ◽  
Hospital Acquired

OBJECTIVESTo estimate the incidence and identified risk factors for community-acquired (CA) and hospital-acquired (HA) Clostridium difficile infection (CDI)METHODSWe conducted 2 parallel case-control studies at Tel Aviv Sourasky Medical Center from January 1, 2011, to December 31, 2014. We identified persons with CDI, determined whether infection was community or hospital acquired, and calculated incidence rates from 2007 to 2014. We collected demographic, clinical, and epidemiological information for CDI cases and hospitalized control cases and estimated the odds ratio with 95% confidence interval using conditional logistic regression.RESULTSIn total, 1,563 CDI cases were identified in the study. The incidence rate of CA-CDI and HA-CDI increased by 1.6-fold and 1.2-fold, respectively, during 2012–2014. However, the incidence rate of CA-CDI was 0.84 per 100,000 (95% CI, 0.52–1.30), the rate for HA-CDI was 4.7 per 10,000 patient days (95% CI, 4.08–5.38), respectively, in 2014. We identified several factors as independent variables significantly associated with HA-CDI: functional disability, presence of nasogastric tube, antibiotic use, chemotherapy, infection by extended-spectrum β-lactamases, and mean of albumin values. Risk factors independently associated with CA-CDI were close contact with a family member who had been hospitalized in the previous 6 months, inflammatory bowel disease, and home density index (adjusted odds ratio, 25.7; 95% confidence interval, 3.99–165.54; P=.001).CONCLUSIONSThe identification of the main modifiable risk factors for HA-CDI (antibiotic exposure and hypoalbuminemia) and for CA-CDI (close contact with a family member who had been hospitalized in the previous 6 months) is likely to optimize prevention efforts; these factors are critical in preventing the spread of CDI.Infect Control Hosp Epidemiol 2017;38:912–920

scholarly journals An Assessment of 2016 National Healthcare Safety Network (NHSN) and National Electronic Disease Surveillance System (NEDSS) Clostridium difficile Infections (CDI) in Nebraska

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S399-S399
Author(s):  
Caitlin Pedati ◽  
Madison Sullivan ◽  
Margaret Drake ◽  
Alison Keyser ◽  
Tom Safranek ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Surveillance System ◽  
Disease Surveillance ◽  
Healthcare Facility ◽  
Data Sources ◽  
National Healthcare ◽  
Disease Surveillance System ◽  
Department Of Health ◽  
National Healthcare Safety Network ◽  
Community Onset

Abstract Background In 2016 all acute care hospitals, inpatient rehab facilities, and PPS-exempt cancer facilities in Nebraska were required to report laboratory identified (LabID) Clostridium difficile infections (CDIs) to the National Healthcare Safety Network (NHSN). Test results indicating CDIs must be reported to the Nebraska Department of Health and Human Services (NDHHS) via the National Electronic Disease Surveillance System (NEDSS). NHSN and NEDSS represent unique sources of CDI reports in Nebraska. Methods The NHSN Nebraska database was queried for CDIs reported in 2016. All lab tests indicating a CDI in 2016 were extracted from NEDSS. These extracts were analyzed to assess descriptive epidemiologic variables and compared for differences. Results In 2016 there were 1,546 CDI LabID events reported to NHSN Nebraska from 28 facilities. There were 249 outpatient CDIs and 1,297 inpatient CDIs. Infections were further characterized as community-onset (N = 773), community-onset, healthcare facility associated (N = 206), and hospital onset (N = 567). An average of 128 CDIs were reported per month (range: 111–155). In 2016 there were 2,177 lab results indicating a CDI reported to NEDSS among Nebraska residents from 42 facilities. Patient ages ranged from 4 months to 104 years (mean = 58 years). An average of 181 CDIs were reported per month (range: 151–218). Comparison of the two data sources found 781 reports among 591 unique patients at 11 facilities that were made to NHSN and were not in NEDSS. Additionally, there were 1,092 reports from 931 unique patients at 12 facilities that were made to NEDSS and should have been made to NHSN but were not. There were 9 shared facilities that accounted for the majority of these discrepancies. Conclusion NHSN and NEDSS represent two unique data sources that allow for a more comprehensive assessment of CDIs. The number and type of facility that report to each system is slightly different but there is some overlap. Therefore, this comparison allows for detection of a greater number of reports overall and also provides an opportunity for data validation. This assessment identified discrepancies in reporting among 9 facilities that can be targeted for further collaborative efforts to improve CDI reporting and management in Nebraska. Disclosures All authors: No reported disclosures.

Quantifying Sources of Bias in National Healthcare Safety Network Laboratory-Identified Clostridium difficile Infection Rates

2014 ◽  
Vol 35 (1) ◽  
pp. 1-7 ◽  
Author(s):  
Valerie B. Haley ◽  
A. Gregory DiRienzo ◽  
Emily C. Lutterloh ◽  
Rachel L. Stricof
Keyword(s):  
At Risk ◽  
New York ◽  
Clostridium Difficile ◽  
The State ◽  
Patient Age ◽  
Data Set ◽  
National Healthcare ◽  
National Healthcare Safety Network ◽  
Patient Âgé ◽  
Not At Risk

Objective.To assess the effect of multiple sources of bias on state- and hospital-specific National Healthcare Safety Network (NHSN) laboratory-identified Clostridium difficile infection (CDI) rates.Design.Sensitivity analysis.Setting.A total of 124 New York hospitals in 2010.Methods.New York NHSN CDI events from audited hospitals were matched to New York hospital discharge billing records to obtain additional information on patient age, length of stay, and previous hospital discharges. “Corrected” hospital-onset (HO) CDI rates were calculated after (1) correcting inaccurate case reporting found during audits, (2) incorporating knowledge of laboratory results from outside hospitals, (3) excluding days when patients were not at risk from the denominator of the rates, and (4) adjusting for patient age. Data sets were simulated with each of these sources of bias reintroduced individually and combined. The simulated rates were compared with the corrected rates. Performance (ie, better, worse, or average compared with the state average) was categorized, and misclassification compared with the corrected data set was measured.Results.Counting days patients were not at risk in the denominator reduced the state HO rate by 45% and resulted in 8% misclassification. Age adjustment and reporting errors also shifted rates (7% and 6% misclassification, respectively).Conclusions.Changing the NHSN protocol to require reporting of age-stratified patient-days and adjusting for patient-days at risk would improve comparability of rates across hospitals. Further research is needed to validate the risk-adjustment model before these data should be used as hospital performance measures.

scholarly journals Impact of 2018 Changes in National Healthcare Safety Network Surveillance for Clostridium difficile Laboratory-Identified Event Reporting

2018 ◽  
Vol 39 (07) ◽  
pp. 886-888 ◽  
Author(s):  
Alexandre R. Marra ◽  
Michael B. Edmond ◽  
Bradley A. Ford ◽  
Loreen A. Herwaldt ◽  
Abdullah R. Algwizani ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Event Reporting ◽  
National Healthcare ◽  
National Healthcare Safety Network ◽  
Network Surveillance
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