Clostridioides difficile on Ohio swine farms (2015): A comparison of swine and human environments and assessment of on‐farm risk factors

2019 ◽  
Vol 66 (7) ◽  
pp. 861-870
Author(s):  
Rory A. O’Shaughnessy ◽  
Gregory G. Habing ◽  
Wondwossen A. Gebreyes ◽  
Andrew S. Bowman ◽  
J. Scott Weese ◽  
...  
Keyword(s):  
Risk Factors ◽  
Swine Farms ◽  
Clostridioides Difficile ◽  
On Farm

scholarly journals Risk factors for development of initial Clostridioides difficile infection

2021 ◽  
Vol 25 ◽  
pp. 18-22
Author(s):  
Jamie L. Wagner ◽  
Kayla R. Stover ◽  
Allison M. Bell ◽  
Katie E. Barber
Keyword(s):  
Risk Factors ◽  
Clostridioides Difficile ◽  
Clostridioides Difficile Infection

Comorbidity and severity-of-illness risk adjustment for hospital-onset Clostridioides difficile infection using data from the electronic medical record

2020 ◽  
pp. 1-7
Author(s):  
Stephanie M. Cabral ◽  
Katherine E. Goodman ◽  
Natalia Blanco ◽  
Surbhi Leekha ◽  
Larry S. Magder ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Risk Adjustment ◽  
Community Hospital ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Bivariate Analysis ◽  
Patient Admissions ◽  
Clostridioides Difficile ◽  
Risk Adjustment Model

Abstract Objective: To determine whether electronically available comorbidities and laboratory values on admission are risk factors for hospital-onset Clostridioides difficile infection (HO-CDI) across multiple institutions and whether they could be used to improve risk adjustment. Patients: All patients at least 18 years of age admitted to 3 hospitals in Maryland between January 1, 2016, and January 1, 2018. Methods: Comorbid conditions were assigned using the Elixhauser comorbidity index. Multivariable log-binomial regression was conducted for each hospital using significant covariates (P < .10) in a bivariate analysis. Standardized infection ratios (SIRs) were computed using current Centers for Disease Control and Prevention (CDC) risk adjustment methodology and with the addition of Elixhauser score and individual comorbidities. Results: At hospital 1, 314 of 48,057 patient admissions (0.65%) had a HO-CDI; 41 of 8,791 patient admissions (0.47%) at community hospital 2 had a HO-CDI; and 75 of 29,211 patient admissions (0.26%) at community hospital 3 had a HO-CDI. In multivariable regression, Elixhauser score was a significant risk factor for HO-CDI at all hospitals when controlling for age, antibiotic use, and antacid use. Abnormal leukocyte level at hospital admission was a significant risk factor at hospital 1 and hospital 2. When Elixhauser score was included in the risk adjustment model, it was statistically significant (P < .01). Compared with the current CDC SIR methodology, the SIR of hospital 1 decreased by 2%, whereas the SIRs of hospitals 2 and 3 increased by 2% and 6%, respectively, but the rankings did not change. Conclusions: Electronically available patient comorbidities are important risk factors for HO-CDI and may improve risk-adjustment methodology.

scholarly journals Systematic Literature Review on Burden of Clostridioides difficile Infection in India

2021 ◽  
Vol 14 ◽  
pp. 2632010X2110138
Author(s):  
Canna J Ghia ◽  
Shaumil Waghela ◽  
Gautam S Rambhad
Keyword(s):  
Risk Factors ◽  
Multiple Testing ◽  
Final Analysis ◽  
Antibiotic Usage ◽  
Diagnostic Methods ◽  
North India ◽  
Enzyme Linked Immunosorbent Assay ◽  
Chi Square ◽  
Clostridioides Difficile ◽  
The Impact

Background: Owing to limited diagnostic facilities and surveillance protocols, there is a paucity on the prevalence data of Clostridioides difficile infections (CDIs) in developing countries such as India. Objective: The aims of these studies are (1) to determine the prevalence of CDI in India, (2) to understand the risk factors of CDI, and (3) to determine the impact of different diagnostic methods on reported CDI rates. Method: A systematic literature search was conducted using PubMed and Google Scholar database to identify Indian studies reporting the prevalence of CDI. A total of 31 studies, published between 1990 and 2020 were included in the final analysis. A chi-square test was used to determine statistically significant association between prevalence rates, accuracy of different diagnosis methods, and antibiotic usage rates of CDI. Results: The prevalence of CDI was in the range of 3.4% to 18%, and the difference between regional prevalence of CDI was statistically significant ( P < .001). The use of antibiotics, hospital stay, comorbidities, recent surgery, and the use of proton-pump inhibitors was considered as risk factors for the development of CDI. Compared to other regions, the rate of antibiotic usage was significantly higher in North India ( P < .001). Among different diagnostic methods, C. difficile detection was significantly higher with enzyme-linked immunosorbent assay (18.02%) versus other multiple testing methods used ( P < .001). Conclusion: There is a significant burden of CDI across the country. Further surveillance studies are required to monitor changes in prevalence of CDI, risk factors, and accuracy of diagnosis methods for a better understanding of the disease burden in India.

Importance of on-farm management practices on lactate-fermenting Clostridium spp. spore contamination of Manchega ewe milk: Determination of risk factors and characterization of Clostridium population

2013 ◽  
Vol 111 (1-3) ◽  
pp. 120-128 ◽  
Author(s):  
C. Arias ◽  
B. Oliete ◽  
S. Seseña ◽  
L. Jimenez ◽  
M.D. Pérez-Guzmán ◽  
...  
Keyword(s):  
Risk Factors ◽  
Management Practices ◽  
Farm Management ◽  
On Farm ◽  
Clostridium Spp

scholarly journals Use of carbapenems and glycopeptides increases risk for Clostridioides difficile infections in acute myeloid leukemia patients undergoing intensive induction chemotherapy

2020 ◽  
Vol 99 (11) ◽  
pp. 2547-2553
Author(s):  
Olivier Ballo ◽  
Eva-Maria Kreisel ◽  
Fagr Eladly ◽  
Uta Brunnberg ◽  
Jan Stratmann ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Myeloid Leukemia ◽  
Induction Chemotherapy ◽  
Myeloid Leukemia ◽  
Bacterial Infections ◽  
Treatment Strategies ◽  
Length Of Hospital Stay ◽  
Infectious Complications ◽  
Clostridioides Difficile ◽  
Acute Myeloid

Abstract Patients with acute myeloid leukemia (AML) are often exposed to broad-spectrum antibiotics and thus at high risk of Clostridioides difficile infections (CDI). As bacterial infections are a common cause for treatment-related mortality in these patients, we conducted a retrospective study to analyze the incidence of CDI and to evaluate risk factors for CDI in a large uniformly treated AML cohort. A total of 415 AML patients undergoing intensive induction chemotherapy between 2007 and 2019 were included in this retrospective analysis. Patients presenting with diarrhea and positive stool testing for toxin-producing Clostridioides difficile were defined to have CDI. CDI was diagnosed in 37 (8.9%) of 415 AML patients with decreasing CDI rates between 2013 and 2019 versus 2007 to 2012. Days with fever, exposition to carbapenems, and glycopeptides were significantly associated with CDI in AML patients. Clinical endpoints such as length of hospital stay, admission to ICU, response rates, and survival were not adversely affected. We identified febrile episodes and exposition to carbapenems and glycopeptides as risk factors for CDI in AML patients undergoing induction chemotherapy, thereby highlighting the importance of interdisciplinary antibiotic stewardship programs guiding treatment strategies in AML patients with infectious complications to carefully balance risks and benefits of anti-infective agents.

scholarly journals 1498. Assess Risk Factors, Mortality, and Healthcare Utilization Associated with Clostridioides difficile Infection (CDI) in 4 Latin American Countries

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S545-S545
Author(s):  
Holly Yu ◽  
Nestor Flaster ◽  
Adrian Casanello ◽  
Daniel Curcio
Keyword(s):  
Risk Factors ◽  
Latin America ◽  
Hospital Admission ◽  
Healthcare Utilization ◽  
Latin American ◽  
Conditional Logistic Regression ◽  
Developed Countries ◽  
Hospital Death ◽  
Clostridioides Difficile ◽  
Clostridioides Difficile Infection

Abstract Background In contrast to Europe and North America, little is known about Clostridioides difficile infection (CDI) in Latin America, especially about risk factors, mortality, and healthcare utilization. Methods We conducted a retrospective, case–control study at eight hospital centers in Brazil, Mexico, Argentina, and Chile. Hospital databases and medical records were used to identify nosocomial CDI cases from January 1, 2014 to December 31, 2017. CDI cases were patients with diarrhea and a positive CDI testing ≥72 hours after hospital admission. Two controls with no CDI diagnosis and diarrhea were matched to each CDI case and were required to (1) have a length of hospital stay (LOS) ≥ 3 days, (2) be admitted ±14 days from the case, and (3) share the same ward. Risk factors associated with CDI were assessed by conditional logistic regression. Mortality and healthcare utilization were compared between cases and controls. Results A total of 1,443 patients (≥18 years old) who met eligibility criteria were selected (481 cases and 962 controls). Comparing cases to controls, the mean age and gender representation were similar (age: 58.7 vs. 56.7 years, P = 0.269; male: 56.3% vs. 53.4%, P = 0.293), but comorbidity was higher (mean Charlson Comorbidity index: 4.3 vs. 3.6, p Conclusion Antibiotic exposure, existing medical conditions, and recent hospital admission are CDI major risk factors in Latin America. CDI also increased in-hospital death risk and LOS. These findings are consistent with published literature in developed countries. Disclosures All authors: No reported disclosures.

scholarly journals Risk Factors Associated with Carbapenemase-Producing Enterobacterales (CPE) Positivity in the Hospital Wastewater Environment

2020 ◽  
Vol 86 (24) ◽  
Author(s):  
Stacy C. Park ◽  
Hardik Parikh ◽  
Kasi Vegesana ◽  
Nicole Stoesser ◽  
Katie E. Barry ◽  
...  
Keyword(s):  
Risk Factors ◽  
Klebsiella Pneumoniae ◽  
Hospital Environment ◽  
Hospital Wastewater ◽  
Content Type ◽  
The Past ◽  
Clostridioides Difficile ◽  
Increased Risk ◽  
Increase Risk ◽  
Gram Negative Organisms

ABSTRACT Hospital wastewater is an increasingly recognized reservoir for resistant Gram-negative organisms. Factors involved in establishment and persistence of Klebsiella pneumoniae carbapenemase-producing organisms (KPCOs) in hospital wastewater plumbing are unclear. This study was conducted at a hospital with endemic KPCOs linked to wastewater reservoirs and robust patient perirectal screening for silent KPCO carriage. Over 5 months, both rooms occupied and rooms not occupied by KPCO-positive patients were sampled at three wastewater sites within each room (sink drain, sink P-trap, and toilet or hopper). Risk factors for KPCO positivity were assessed using logistic regression. Whole-genome sequencing (WGS) identified environmental seeding by KPCO-positive patients. A total of 219/475 (46%) room sampling events were KPCO positive in at least one wastewater site. KPCO-positive patient exposure was associated with increased risk of environmental positivity for the room and toilet/hopper. Previous positivity and intensive care unit room type were consistently associated with increased risk. Tube feeds were associated with increased risk for the drain, while exposure to patients with Clostridioides difficile was associated with decreased risk. Urinary catheter exposure was associated with increased risk of P-trap positivity. P-trap heaters reduced risk of P-trap and sink drain positivity. WGS identified genomically linked environmental seeding in 6 of 99 room occupations by 40 KPCO-positive patients. In conclusion, KPCO-positive patients seed the environment in at least 6% of opportunities; once positive for KPCOs, wastewater sites are at greater risk of being positive subsequently. Increased nutrient exposure, e.g., due to tube food disposal down sinks, may increase risk; frequent flushing may be protective. IMPORTANCE Klebsiella pneumoniae carbapenemase-producing organisms (KPCOs) are bacteria that are resistant to most antibiotics and thus are challenging to treat when they cause infections in patients. These organisms can be acquired by patients who are hospitalized for other reasons, complicating their hospital stay and even leading to death. Hospital wastewater sites, such as sink drains and toilets, have played a role in many reported outbreaks over the past decade. The significance of our research is in identifying risk factors for environmental positivity for KPCOs, which will facilitate further work to prevent transmission of these organisms to patients from the hospital environment.

Burden and risk factors for inappropriate Clostridioides Difficile infection testing among hospitalized patients

2021 ◽  
Vol 99 (4) ◽  
pp. 115283
Author(s):  
Ellen Axenfeld ◽  
William G. Greendyke ◽  
Jianhua Li ◽  
Daniel A. Green ◽  
Susan Whittier ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hospitalized Patients ◽  
Clostridioides Difficile ◽  
Clostridioides Difficile Infection

On farm risk factors associated with goat milk quality in Northeast Brazil

2011 ◽  
Vol 98 (1-3) ◽  
pp. 64-69 ◽  
Author(s):  
C.J.B. Oliveira ◽  
E.R. Hisrich ◽  
J.F.P. Moura ◽  
P.E.N. Givisiez ◽  
R.G.Costa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Goat Milk ◽  
Milk Quality ◽  
Northeast Brazil ◽  
Factors Associated ◽  
On Farm

scholarly journals Caretaker attitudes toward swine euthanasia1

2018 ◽  
Vol 2 (3) ◽  
pp. 254-262 ◽  
Author(s):  
Magnus R Campler ◽  
Monique D Pairis-Garcia ◽  
Jean-Loup Rault ◽  
Grahame Coleman ◽  
Andreia G Arruda
Keyword(s):  
Work Experience ◽  
Strongly Correlated ◽  
Perceived Knowledge ◽  
Swine Farms ◽  
Fundamental Part ◽  
Average Work ◽  
Survey Results ◽  
Level Of Knowledge ◽  
The Individual ◽  
On Farm

Abstract Timely euthanasia is a fundamental part of safeguarding swine welfare by reducing suffering when compromised pigs are unable to recover. The quality and appropriateness of timely euthanasia rely mainly on the knowledge and experience of the individual caretaker but may also be affected by caretaker attitudes toward euthanasia. However, literature on caretaker attitudes toward swine euthanasia is lacking. This study investigated caretaker attitudes, perceived knowledge, and confidence in performing on-farm timely euthanasia. A total of 84 caretakers from eight swine farms (ranging in size from 1,300 to 7,000 sows) participated in a survey designed to investigate attitudes toward swine and swine euthanasia. Caretaker’s ages ranged from 18 to 59 yr with an average work experience of 8.5 yr. The majority of participants worked in either farrowing or breeding units. Survey questions were designed to assess caretakers’ attitudes and attributes (empathy affect, empathy attribution, attitudes toward pigs, feeling bad about euthanizing pigs, and assumptions about pigs’ emotional capabilities), decision-making skills (confidence in identifying compromised pigs or relying on coworkers to make decisions), and euthanasia skillset (confidence in performing euthanasia, training, and perceived level of knowledge). Using cluster analysis to analyze survey answers, three distinct groups of caretakers were identified: 1) confident and empathetic; 2) Confident, knowledgeable, and detached; and 3) unconfident and lacking knowledge. The survey results showed that empathy attribution was strongly correlated with empathy affect (r = 0.571, P &lt; 0.01) and that empathy affect and empathy attribution were higher in female caretakers compared with male caretakers (P &lt; 0.05). A risk analysis that included previously identified clusters showed that females were more likely to be grouped among caretakers that were confident and empathetic (P = 0.04), and caretakers with more than 2 yr of swine experience were more likely to be grouped as confident and skilled (P = 0.01), while the unconfident and empathetic were more likely to have had less than 2 yr of experience (P = 0.04). This study provides important information about variability in caretaker experience as well as their attitudes toward pigs and timely euthanasia. Increased knowledge about swine caretaker attitudes may be used to implement training and euthanasia protocols to increase both human and pig welfare on farm.

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