scholarly journals Clostridium difficile Infection Rates Reduced at a Health Care System after Restriction of Respiratory Fluoroquinolones

2017 ◽  
Vol 05 (04) ◽  
Author(s):  
Athena LV Hobbs ◽  
Katherine M Shea
Keyword(s):  
Health Care ◽  
Clostridium Difficile ◽  
Health Care System ◽  
Clostridium Difficile Infection ◽  
Infection Rates ◽  
Care System

scholarly journals Clostridium difficile binary toxin (CDT) is recognized by the TLR2/6 heterodimer to induce an NF-κB response

2020 ◽  
Author(s):  
Morgan Simpson ◽  
Alyse Frisbee ◽  
Pankaj Kumar ◽  
Carsten Schwan ◽  
Klaus Aktories ◽  
...  
Keyword(s):  
Health Care ◽  
Clostridium Difficile ◽  
Health Care System ◽  
Host Immunity ◽  
Binary Toxin ◽  
Clostridioides Difficile ◽  
Significant Burden ◽  
The Impact ◽  
Care System

AbstractClostridioides difficile infection (CDI) represents a significant burden on the health care system, one that is exacerbated by the emergence of binary toxin (CDT)-producing hypervirulent C. difficile strains. Previous work from our lab has shown that TLR2 recognizes CDT to induce inflammation. Here we explore the interactions of CDT with TLR2 and the impact on host immunity during CDI. We found that the TLR2/6 heterodimer, not TLR2/1, is responsible for CDT recognition, and that gene pathways including NF-κB and MAPK downstream of TLR2/6 are upregulated in mice with intact TLR2/6 signaling during CDI.

scholarly journals Effect of a Health Care System Respiratory Fluoroquinolone Restriction Program To Alter Utilization and Impact Rates of Clostridium difficile Infection

2017 ◽  
Vol 61 (6) ◽  
Author(s):  
Katherine M. Shea ◽  
Athena L. V. Hobbs ◽  
Theresa C. Jaso ◽  
Jack D. Bissett ◽  
Christopher M. Cruz ◽  
...  
Keyword(s):  
Health Care ◽  
Clostridium Difficile ◽  
Health Care System ◽  
Acquisition Cost ◽  
The United States ◽  
Content Type ◽  
Days Of Therapy ◽  
Segmented Regression Analysis ◽  
The Impact ◽  
Care System

ABSTRACT Fluoroquinolones are one of the most commonly prescribed antibiotic classes in the United States despite their association with adverse consequences, including Clostridium difficile infection (CDI). We sought to evaluate the impact of a health care system antimicrobial stewardship-initiated respiratory fluoroquinolone restriction program on utilization, appropriateness of quinolone-based therapy based on institutional guidelines, and CDI rates. After implementation, respiratory fluoroquinolone utilization decreased from a monthly mean and standard deviation (SD) of 41.0 (SD = 4.4) days of therapy (DOT) per 1,000 patient days (PD) preintervention to 21.5 (SD = 6.4) DOT/1,000 PD and 4.8 (SD = 3.6) DOT/1,000 PD posteducation and postrestriction, respectively. Using segmented regression analysis, both education (14.5 DOT/1,000 PD per month decrease; P = 0.023) and restriction (24.5 DOT/1,000 PD per month decrease; P < 0.0001) were associated with decreased utilization. In addition, the CDI rates decreased significantly (P = 0.044) from preintervention using education (3.43 cases/10,000 PD) and restriction (2.2 cases/10,000 PD). Mean monthly CDI cases/10,000 PD decreased from 4.0 (SD = 2.1) preintervention to 2.2 (SD = 1.35) postrestriction. A significant increase in appropriate respiratory fluoroquinolone use occurred postrestriction versus preintervention in patients administered at least one dose (74/130 [57%] versus 74/232 [32%]; P < 0.001), as well as in those receiving two or more doses (47/65 [72%] versus 67/191 [35%]; P < 0.001). A significant reduction in the annual acquisition cost of moxifloxacin, the formulary respiratory fluoroquinolone, was observed postrestriction compared to preintervention within the health care system ($123,882 versus $12,273; P = 0.002). Implementation of a stewardship-initiated respiratory fluoroquinolone restriction program can increase appropriate use while reducing overall utilization, acquisition cost, and CDI rates within a health care system.

scholarly journals Economic burden of Clostridium difficile in five hospitals of the Florence health care system in Italy

2015 ◽  
pp. 207 ◽  
Author(s):  
Giorgio Lorenzo Colombo ◽  
Anna Poli ◽  
Enrica Fornai ◽  
Giacomo M. Bruno ◽  
M. Chiara Valentino ◽  
...  
Keyword(s):  
Health Care ◽  
Clostridium Difficile ◽  
Health Care System ◽  
Economic Burden ◽  
Care System

Impact of an electronic sepsis initiative on antibiotic use and health care facility–onset Clostridium difficile infection rates

2017 ◽  
Vol 45 (10) ◽  
pp. 1091-1100 ◽  
Author(s):  
Robert Hiensch ◽  
Jashvant Poeran ◽  
Patricia Saunders-Hao ◽  
Victoria Adams ◽  
Charles A. Powell ◽  
...  
Keyword(s):  
Health Care ◽  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Care Facility ◽  
Health Care Facility ◽  
Antibiotic Use ◽  
Infection Rates

Teletinnitus Program at the VA Gulf Coast Veterans Health Care System

2014 ◽  
Vol 4 (1) ◽  
pp. 23-29
Author(s):  
Constance Hilory Tomberlin
Keyword(s):  
Health Care ◽  
Patient Satisfaction ◽  
Patient Care ◽  
Health Care System ◽  
Gulf Coast ◽  
New Technology ◽  
Cost Effective ◽  
Veterans Health ◽  
Potential Benefits ◽  
Care System

There are a multitude of reasons that a teletinnitus program can be beneficial, not only to the patients, but also within the hospital and audiology department. The ability to use technology for the purpose of tinnitus management allows for improved appointment access for all patients, especially those who live at a distance, has been shown to be more cost effective when the patients travel is otherwise monetarily compensated, and allows for multiple patient's to be seen in the same time slots, allowing for greater access to the clinic for the patients wishing to be seen in-house. There is also the patient's excitement in being part of a new technology-based program. The Gulf Coast Veterans Health Care System (GCVHCS) saw the potential benefits of incorporating a teletinnitus program and began implementation in 2013. There were a few hurdles to work through during the beginning organizational process and the initial execution of the program. Since the establishment of the Teletinnitus program, the GCVHCS has seen an enhancement in patient care, reduction in travel compensation, improvement in clinic utilization, clinic availability, the genuine excitement of the use of a new healthcare media amongst staff and patients, and overall patient satisfaction.

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