scholarly journals The Effect of Bundled Interventions on Prevention of Hospital Acquired Clostridium Difficile Infection: An Integrative Review

2017 ◽  
Vol 4 (2) ◽  
Author(s):  
Kendys K
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Integrative Review ◽  
Hospital Acquired

scholarly journals Probiotics to Reduce Clostridium difficile Infection: Clinical Experience in a Tertiary Care Center

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S384-S384
Author(s):  
Maggie Box ◽  
Kristine Ortwine ◽  
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Primary Outcome ◽  
Care Center ◽  
Tertiary Care ◽  
Concomitant Administration ◽  
Antibiotic Exposure ◽  
Time Period ◽  
Probiotic Preparation ◽  
Hospital Acquired

Abstract Background There is conflicting clinical data regarding the efficacy of probiotics to prevent Clostridium difficile infection (CDI). The goal of this study is to compare rates of hospital acquired Clostridium difficile infection (HA-CDI) among patients receiving antibiotics with or without concomitant administration of probiotics. Methods This retrospective, cohort study compares hospitalized patients who received antibiotics alone vs. antibiotics plus a multi-strain probiotic preparation of lactobacillus over a six month time period. Probiotics were given at the discretion of the physician. The primary outcome was incidence in HA-CDI (defined as onset after hospital day three) between groups. Results A total of 1,576 patients met selection criteria, with 927 patients receiving antibiotics alone and 649 patients receiving antibiotics plus probiotics. HA-CDI rates were 0.9% and 1.8% (P = 0.16), respectively. In a subgroup analysis of patients in the antibiotic only group, patients who received similar antibiotic exposure as the probiotics group (n = 284) had no difference in rates of HA-CDI (1.8% vs. 1.8%; P = 1.0). Conclusion Probiotic administration did not decrease rates of HA-CDI in our institution. We recommend prioritizing resources to other CDI reduction measures such as decreasing antibiotic exposure and preventing transmission. Disclosures All authors: No reported disclosures.

scholarly journals The Effect of Hospital-Acquired Clostridium difficile Infection on In-Hospital Mortality

2010 ◽  
Vol 170 (20) ◽  
Author(s):  
Natalie Oake ◽  
Monica Taljaard ◽  
Carl van Walraven ◽  
Kumanan Wilson ◽  
Virginia Roth ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Hospital Mortality ◽  
Clostridium Difficile Infection ◽  
Hospital Acquired

scholarly journals The Use of Probiotics in the Prevention of Clostridium Difficile Infection

2016 ◽  
Author(s):  
Lindsay Mook
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Healthcare Providers ◽  
Hospital Setting ◽  
Retrospective Chart Review ◽  
The United States ◽  
Hospitalized Patients ◽  
Study Results ◽  
Prescribing Trends ◽  
Hospital Acquired

<p>Despite advances in the diagnosis and treatment of Clostridium difficile infection (CDI), the prevention of CDI, particularly in the inpatient hospital setting, remains a challenge. Clostridium difficile now rivals methicillin-resistant staphylococcus aureus (MRSA) as the most common pathogen to cause hospital acquired infections (HAI) in the United States. Hospitalized patients are considered to be especially high risk for CDI, and among inpatient cases, antibiotic treatment, especially with Fluoroquinolones has been an almost universal factor in the development of CDIs. One preventative measure that is incontinently used in the prevention of CDI is oral probiotics. Probiotic consumption is reported to exert a myriad of beneficial effects including enhanced immune response, balancing of colonic microbiota, treatment of diarrhea associated with travel and antibiotic therapy, control of rotavirus and clostridium difficile induced colitis. The American College of Gastroenterology recognizes the role of probiotics and included probiotics as a level B recommendation for the treatment of CDI. It has been hypothesized that the use of probiotics, as an adjunctive therapy in patients receiving antibiotics, may provide a key intervention in reducing primary CDI. The purpose of this study was to conduct a retrospective chart review to explore healthcare providers prescribing trends regarding Fluoroquinolone antibiotics and adjunctive probiotics in patients with hospital acquired CDI. The Synergy model was used to guide the study. Results indicated that probiotics are not frequently prescribed for hospitalized patients on Fluoroquinolones and when they are it is with inconsistency. Additional research is recommended to further assess the use of probiotics in conjunction with other classes of commonly used antibiotics; this study solely looked at Fluoroquinolones.</p>

scholarly journals An effect of single high dose of vitamin D3 on the risk of nosocomial infections, hospitalization time and mortality in hospitalized elderly population. A preliminary report

2020 ◽  
Vol 2 (2) ◽  
pp. 1-5
Author(s):  
Dorota Leszczyńska ◽  
Agata Tuszyńska ◽  
Magdalena Zgliczyńska ◽  
Wojciech Zgliczyński ◽  
Waldemar Misiorowski
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Vitamin D3 ◽  
Nosocomial Infections ◽  
Control Group ◽  
High Dose ◽  
Single High Dose ◽  
Hospital Acquired Infections ◽  
Hospital Acquired ◽  
The Impact

Introduction: Observational studies indicate a significant impact of serum 25(OH)D concentration on incidence of hospital-acquired infections. However, we did not find any interventional study assessing the effect of vitamin D3 administration at the admission on the course of further hospitalization in internal medicine departments. Objective of the paper: Investigation of the impact of one-time high-dose vitamin D3 administration in elderly patients on the day of urgent admission to the hospital, on hospital-acquired infections. Materials and methods: A randomized, two-arms, open pilot study in 97 adults aged 60-100. A study group was given a single dose of 60,000 IU vitamin D3 and a control group was not subject to any intervention. Serum 25(OH)D and calcium were measured at the baseline and after 7 days. Results: 77.32% of studied patients were vitamin deficient, and among those, in 28.87% severe vitamin D deficiency was found. After single administration of 60,000 IU of vitamin D3, only 4 patients achieved recommended serum 25(OH)D concentration. The highest increase in serum 25(OH)D was observed in patients with severe deficiency. Numbers of observed nosocomial infections such as flu, hospital-acquired pneumonia or Klebsiella pneumoniae MBL+ infection did not differ significantly between study and control group, however there was a trend close to significance for lower incidence of Clostridium difficile infection in the vitamin D3 group. Conclusions: Preliminary results of the presented research indicate possible protective effect of single high dose of vitamin D3 against Clostridium difficile infection during hospitalization. Further research on larger group of patients, using higher dose of vitamin D3 is necessary.

scholarly journals 1990. A Strategy of Mandatory Infectious Disease Consultations on Hospital-acquired Clostridium difficile Infection and Antimicrobial Utilization

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S667-S668
Author(s):  
Cindy Hou ◽  
Nikunj M Vyas ◽  
Todd P Levin ◽  
David Condoluci
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Pearson Correlation ◽  
Hospital System ◽  
Stewardship Program ◽  
Antimicrobial Utilization ◽  
Days Of Therapy ◽  
Correlation Statistics ◽  
Sepsis And Septic Shock ◽  
Hospital Acquired

Abstract Background An antibiotic stewardship program (ASP) is critical to ensure the appropriateness of treatment for infections and to help avert Clostridium difficile infection (CDI). In a three-hospital system, infection preventionists (IP) found that hospital-acquired CDI rates were higher than expected in spite of a robust ASP program. The Medical Executive Board mandated infectious diseases (ID) consults for all patients with sepsis, severe sepsis, and septic shock. If consults to ID are mandatory, the hypothesis is that this may help to lower antibiotic days of therapy (DOT)/1,000 patient-days (PD) and HO-CDI rates. Methods The ASP program started in November 2014, and mandatory ID consults for all types of sepsis started in March 2016. Data were selected from the time period between 2014 (Quarter 1) to 2017 (Quarter 2). The IP assessed the HO-CDI, and business intelligence generated a monthly report of the total number of ID consults (for any infectious diagnosis). The researchers retrospectively analyzed the data and then performed Pearson correlation statistics. Results Data on ID consults at hospital sites A, B, and C were correlated against DOT/1000 PD. Hospital A was statistically significant (P = 0.015) for a moderate correlation—where higher ID consults contributed to decreased DOT/1,000 PD. Hospital B showed moderate significance (P = 0.002), and the strongest correlation was at hospital C (P = 0.0007). Then ID consults at all three hospital sites were compared against HO-CDI rates. Hospital A (P = 0.76) and Hospital B (0.18) did not achieve any correlation. Hospital C was strongly correlated (P = 0.004). Conclusion In a three-hospital system, mandatory ID consults led to moderate to strong correlations with decreased DOT/1,000 PD. However, HO-CDI rates were most likely to decrease at only of the hospitals. Overall, ID consultations should be considered as an antimicrobial stewardship strategy to address the appropriateness of antibiotics and to combat CDI. Disclosures All authors: No reported disclosures.

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