National epidemiology of initial and recurrent Clostridium difficile infection in the Veterans Health Administration from 2003 to 2014

Complications within 30 days of a clinically confirmed hospital-onset Clostridium difficile infection diagnosis from July 1, 2012, through June 30, 2015, in 127 acute care Veterans Health Administration facilities were evaluated. Pooled rates for attributable intensive care unit admissions, colectomies, and deaths were 2.7%, 0.5%, and 0.4%, respectively.Infect Control Hosp Epidemiol 2016;37:717–719

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Prevalence of the Clostridium difficile BI/NAP1/027 strain across the United States Veterans Health Administration

Clinical Microbiology and Infection ◽

10.1016/j.cmi.2017.11.011 ◽

2018 ◽

Vol 24 (8) ◽

pp. 877-881 ◽

Cited By ~ 18

Author(s):

S.E. Giancola ◽

R.J. Williams ◽

C.A. Gentry

Keyword(s):

United States ◽

Clostridium Difficile ◽

Veterans Health Administration ◽

The United States ◽

Veterans Health ◽

Health Administration

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Clostridium difficile Infections in Veterans Health Administration Long-Term Care Facilities

Open Forum Infectious Diseases ◽

10.1093/ofid/ofv131.09 ◽

2015 ◽

Vol 2 (suppl_1) ◽

Author(s):

Jeffrey Reeves ◽

Martin Evans ◽

Loretta Simbartl ◽

Stephen Kralovic ◽

Gary Roselle

Keyword(s):

Clostridium Difficile ◽

Long Term Care ◽

Veterans Health Administration ◽

Veterans Health ◽

Health Administration ◽

Term Care ◽

Care Facilities

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A Propensity-Matched Analysis Between Standard Versus Tapered Oral Vancomycin Courses for the Management of Recurrent Clostridium difficile Infection

Open Forum Infectious Diseases ◽

10.1093/ofid/ofx235 ◽

2017 ◽

Vol 4 (4) ◽

Cited By ~ 6

Author(s):

Chris A Gentry ◽

Stephanie E Giancola ◽

Sharanjeet Thind ◽

George Kurdgelashvili ◽

Grant H Skrepnek ◽

...

Keyword(s):

Clostridium Difficile ◽

Propensity Score ◽

Clostridium Difficile Infection ◽

Statistical Significance ◽

Administrative Database ◽

Secondary Outcome ◽

Health Administration ◽

Oral Vancomycin ◽

Recurrent Clostridium Difficile Infection ◽

All Cause Mortality

Abstract Background This study was conducted to compare clinical outcomes of oral vancomycin courses without taper versus oral vancomycin courses with taper for treatment of recurrent Clostridium difficile infection (CDI). Methods This investigation was a multicenter, retrospective, propensity score-matched analysis study using a Veterans Health Administration national clinical administrative database. Adult patients who were treated for recurrent CDI from any Veterans Affairs Medical Center between June 1, 2011 and October 31, 2016 were included if they were treated with oral vancomycin with or without a tapering regimen. The 2 groups were matched by next-nearest approach from a propensity score formula derived from independent variables associated with the selection of a taper regimen. Results Propensity score matching resulted in 2 well-matched groups consisting of 226 episodes of patients treated with a vancomycin taper regimen and 678 episodes treated by vancomycin regimen without taper. No difference was found for the primary outcome of 180-day recurrence (59 of 226 [26.1%] for taper regimens versus 161 of 678 [23.8%], P = .48). A secondary outcome of 90-day all-cause mortality met statistical significance, favoring a taper regimen (5.31% vs 9.29%, P = .049); however, secondary outcomes of 90-day recurrence and 180-day all-cause mortality were not different. Conclusions Vancomycin taper regimens did not provide benefit over vancomycin regimens without taper in preventing additional CDI recurrence in patients with first or second recurrent episodes in this propensity score-matched analysis.

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An Intervention With Meaning

Crisis ◽

10.1027/0227-5910/a000433 ◽

2017 ◽

Vol 38 (6) ◽

pp. 376-383 ◽

Cited By ~ 2

Author(s):

Brooke A. Levandowski ◽

Constance M. Cass ◽

Stephanie N. Miller ◽

Janet E. Kemp ◽

Kenneth R. Conner

Keyword(s):

High Risk ◽

Qualitative Methodology ◽

Veterans Health Administration ◽

Veterans Health ◽

Safety Planning ◽

Health Administration ◽

Suicide Method ◽

Treatment Providers ◽

Interactive Nature ◽

Behavioral Health Treatment

Abstract. Background: The Veterans Health Administration (VHA) health-care system utilizes a multilevel suicide prevention intervention that features the use of standardized safety plans with veterans considered to be at high risk for suicide. Aims: Little is known about clinician perceptions on the value of safety planning with veterans at high risk for suicide. Method: Audio-recorded interviews with 29 VHA behavioral health treatment providers in a southeastern city were transcribed and analyzed using qualitative methodology. Results: Clinical providers consider safety planning feasible, acceptable, and valuable to veterans at high risk for suicide owing to the collaborative and interactive nature of the intervention. Providers identified the types of veterans who easily engaged in safety planning and those who may experience more difficulty with the process. Conclusion: Additional research with VHA providers in other locations and with veteran consumers is needed.

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