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>

IBD: A Growing and Vulnerable Cohort of Hospitalized Patients with Clostridium difficile Infection

2017 ◽  
Vol 83 (6) ◽  
pp. 605-609 ◽  
Author(s):  
Allan Mabardy ◽  
Justin Mccarty ◽  
Alan Hackford ◽  
Haisar Dao
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Total Colectomy ◽  
The United States ◽  
Primary Diagnosis ◽  
Hospitalized Patients ◽  
Nationwide Inpatient Sample Database ◽  
Rising Incidence ◽  
Inflammatory Bowel ◽  
National Trends

The most recent nationwide data show a rising incidence of Clostridium difficile infection in hospitalized patients with ulcerative colitis (UC). We describe recent national trends with regard to incidence, mortality, and the rate of total colectomy. The Nationwide Inpatient Sample database identified patients admitted to hospitals in the United States with diagnoses of C. difficile and inflammatory bowel disease (IBD) during the study years 2007 to 2013. We analyzed incidence of C. difficile, mortality, and colectomy rates. From 2007 to 2013, incidence of patients with IBD admitted with the primary diagnosis of C. difficile rose faster than the non-IBD population (1.24% to 2.14% vs 0.26% to 0.30%, P < 0.0001) and specifically in the UC population rose from 2.36 to 3.48 per cent (P < 0.001). The mortality of non-IBD patients with C. difficile decreased 47 per cent (3.76% to 1.99%, P = 0.003), whereas mortality of IBD patients with C. difficile decreased 54 per cent (6.08% to 2.79%, P = 0.003). For UC patients with primary diagnosis C. difficile, the percentage undergoing total colectomy decreased by 38 per cent (2.47% vs 1.51%, P = 0.049). The incidence of C. difficile continues to rise in the both the IBD and non-IBD population. Our study shows decreasing mortality for IBD and non-IBD patients with C. difficile but a greater decrease in mortality for IBD patients.

scholarly journals Epidemiology of Clostridium difficile Infection

2013 ◽  
Vol 26 (5) ◽  
pp. 464-475 ◽  
Author(s):  
Daryl D. DePestel ◽  
David M. Aronoff
Keyword(s):  
Clostridium Difficile ◽  
Acute Care ◽  
Clostridium Difficile Infection ◽  
Hospital Setting ◽  
Acute Care Hospital ◽  
Disease Recurrence ◽  
The United States ◽  
Care Hospital ◽  
Term Care ◽  
Populations At Risk

There has been dramatic change in the epidemiology of Clostridium difficile infection (CDI) since the turn of the 21st century noted by a marked increase in incidence and severity, occurring at a disproportionately higher frequency in older patients. Historically considered a nosocomial infection associated with antibiotic exposure, CDI has now also emerged in the community in populations previously considered low risk. Emerging risk factors and disease recurrence represent continued challenges in the management of CDI. The increased incidence and severity associated with CDI has coincided with the emergence and rapid spread of a previously rare strain, ribotype 027. Recent data from the United States and Europe suggest that the incidence of CDI may have reached a crescendo in the recent years and is perhaps beginning to plateau. The acute care direct costs of CDI were estimated to be US$4.8 billion in 2008. However, nearly all the published studies have focused on CDI diagnosed and treated in the acute care hospital setting and fail to measure the burden outside the hospital, including recently discharged patients, outpatients, and those in long-term care facilities. Enhanced surveillance methods are needed to monitor the incidence, to identify populations at risk, and to characterize the molecular epidemiology of strains causing CDI.

scholarly journals Discontinuation of Contact Precautions in Patients with Nosocomial MRSA and VRE Infections During the COVID-19 Pandemic

2021 ◽  
Vol 1 (S1) ◽  
pp. s24-s24
Author(s):  
Marisa Hudson ◽  
Mayar Al Mohajer
Keyword(s):  
Hand Hygiene ◽  
Hospital Setting ◽  
Retrospective Chart Review ◽  
Antibiotic Use ◽  
Hospitalized Patients ◽  
Incidence Density ◽  
Contact Precautions ◽  
Before And After ◽  
Hospital Acquired ◽  
The Impact

Background: Gaps exist in the evidence supporting the benefits of contact precautions for the prevention of methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE). The Centers for Disease Control and Prevention allow suspending contact precautions for MRSA and VRE in cases of gown shortages, as we have seen during the COVID-19 pandemic. We evaluated the impact of discontinuing isolation precautions in hospitalized patients with MRSA and VRE infection, due to gown shortage, on the rate of hospital-acquired (HA) MRSA and VRE infections. Methods: A retrospective chart review was performed on adult patients (n = 2,200) with established MRSA or VRE infection at 5 hospitals in CommonSpirit Health, Texas Division, from March 2019 to October 2020. Data including demographics, infection site, documented symptoms, and antibiotic use were stratified based on patient location (floor vs ICU). Rates of hospital-acquired MRSA and VRE infection before and after the discontinuation of isolation (implemented in March 2020) were compared. Incidence density rate was used to assess differences in the rate of MRSA and VRE infections between pre- and postintervention groups. Results: The rate of hospital-acquired (HA) MRSA infection per 10,000 patient days before the intervention (March 19–February 20) was 12.19, compared to 10.64 after the intervention (March 20–July 20) (P = .038). The rates of HA MRSA bacteremia were 1.13 and 0.93 for the pre- and postintervention groups, respectively (P = .074). The rates of HA VRE per 10,000 patient days were 3.53 and 4.44 for the pre- and postintervention groups, respectively (P = .274). The hand hygiene rates were 0.93 before the intervention and 0.97 after the intervention (P = .028). Conclusions: Discontinuing isolation from MRSA and VRE in the hospital setting did not lead to a statistically significant increase in hospital-acquired MRSA or VRE infections. In fact, rates of hospital-acquired MRSA decreased, likely secondary to improvements in hand hygiene during this period. These results support the implementation of policies for discontinuing contact isolation for hospitalized patients with documented MRSA or VRE infection, particularly during shortages of gowns.Funding: NoDisclosures: None

scholarly journals Identification and Management of Sepsis in the Interventional Radiology Patient

2017 ◽  
Vol 1 ◽  
pp. 3
Author(s):  
Jacqueline Murtha ◽  
Vinit Khanna ◽  
Talia Sasson ◽  
Devang Butani
Keyword(s):  
United States ◽  
Health Care ◽  
Septic Shock ◽  
Interventional Radiology ◽  
Hospital Setting ◽  
The United States ◽  
Clinical Aspects ◽  
Inhospital Mortality ◽  
United States Population ◽  
Hospital Acquired

Sepsis is frequently encountered in the hospital setting and can be community-acquired, health-care-associated, or hospital-acquired. The annual incidence of sepsis in the United States population ranges from 300 to 1031 per 100,000 and is increasing by 13% annually. There is an associated inhospital mortality of 10% for sepsis and >40% for septic shock. Interventional radiology is frequently called on to treat patients with sepsis, and in rarer circumstances, interventional radiologists themselves may cause sepsis. Thus, it is essential for interventional radiologists to be able to identify and manage septic patients to reduce sepsis-related morbidity and mortality. The purpose of this paper is to outline procedures most likely to cause sepsis and delineate important clinical aspects of identifying and managing septic patients.

scholarly journals The Co-Seasonality of Pneumonia and Influenza With Clostridium difficile Infection in the United States, 1993-2008

2013 ◽  
Vol 178 (1) ◽  
pp. 118-125 ◽  
Author(s):  
K. A. Brown ◽  
N. Daneman ◽  
P. Arora ◽  
R. Moineddin ◽  
D. N. Fisman
Keyword(s):  
United States ◽  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
The United States

Clinical epidemiology of Clostridium difficile infection among hospitalized patients with antibiotic-associated diarrhea in a university hospital of Brazil

Anaerobe ◽  
2018 ◽  
Vol 54 ◽  
pp. 65-71 ◽  
Author(s):  
Guilherme Grossi Lopes Cançado ◽  
Rodrigo Otávio Silveira Silva ◽  
Maja Rupnik ◽  
Amanda Pontes Nader ◽  
Joana Starling de Carvalho ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Clinical Epidemiology ◽  
Hospitalized Patients ◽  
University Hospital ◽  
Antibiotic Associated Diarrhea
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