Monitoring Clostridium difficile infection in an acute hospital: prevalence or incidence studies?

Hdl Handle:
http://hdl.handle.net/10147/230396
Title:
Monitoring Clostridium difficile infection in an acute hospital: prevalence or incidence studies?
Authors:
Lavan, A H; McCartan, D P; Downes, M M; Hill, A D K; Fitzpatrick, F
Affiliation:
Department of Surgery, Beaumont Hospital, Smurfit Building, Dublin 9, Ireland, amandalavan@gmail.com.
Citation:
Monitoring Clostridium difficile infection in an acute hospital: prevalence or incidence studies? 2012:notIr J Med Sci
Journal:
Irish journal of medical science
Issue Date:
15-Feb-2012
URI:
http://hdl.handle.net/10147/230396
DOI:
10.1007/s11845-011-0798-x
PubMed ID:
22350440
Abstract:
BACKGROUND: Surveillance of Clostridium difficile infection (CDI) is an essential component of a CDI preventative programme. AIMS: The aim of this study was to evaluate two methods of CDI surveillance. METHODS: Prevalence of CDI, antibiotic use and associated co-morbidity was assessed weekly on two wards over 6 weeks. In addition, CDI incidence surveillance was performed on all new CDI cases over a 13-week period. Cases were assessed for CDI risk factors, disease severity, response to treatment and outcome at 6 months. RESULTS: Clostridium difficile infection prevalence was 3.5% (range 2.9-6.1%) on the medical ward and 1.1% (range 0-3.5%) on the surgical ward. Patients on the medical ward were older and more likely to be colonised with MRSA; however, recent antibiotic use was more prevalent among surgical patients. Sixty-one new CDI cases were audited. Patients were elderly (mean age 71 years) with significant co-morbidity (median age adjusted Charlson co-morbidity score 5). CDI ribotypes included 027 (29 cases) 078 (5) and 106 (4). Eight patients developed severe CDI, seven due to 027. Antibiotic use was common with 56% receiving three or more antibiotics in the preceding 8 weeks. Twenty-four patients had died at 6 months, five due to CDI. CONCLUSION: Clostridium difficile infection prevalence gives a broad overview of CDI and points to areas that require more detailed surveillance and requires little time. However, patient-based CDI incidence surveillance provides a more useful analysis of CDI risk factors, disease and outcome for planning preventative programmes and focusing antibiotic stewardship efforts.
Item Type:
Article
Language:
en
ISSN:
1863-4362

Full metadata record

DC FieldValue Language
dc.contributor.authorLavan, A Hen_GB
dc.contributor.authorMcCartan, D Pen_GB
dc.contributor.authorDownes, M Men_GB
dc.contributor.authorHill, A D Ken_GB
dc.contributor.authorFitzpatrick, Fen_GB
dc.date.accessioned2012-06-25T09:58:29Z-
dc.date.available2012-06-25T09:58:29Z-
dc.date.issued2012-02-15-
dc.identifier.citationMonitoring Clostridium difficile infection in an acute hospital: prevalence or incidence studies? 2012:notIr J Med Scien_GB
dc.identifier.issn1863-4362-
dc.identifier.pmid22350440-
dc.identifier.doi10.1007/s11845-011-0798-x-
dc.identifier.urihttp://hdl.handle.net/10147/230396-
dc.description.abstractBACKGROUND: Surveillance of Clostridium difficile infection (CDI) is an essential component of a CDI preventative programme. AIMS: The aim of this study was to evaluate two methods of CDI surveillance. METHODS: Prevalence of CDI, antibiotic use and associated co-morbidity was assessed weekly on two wards over 6 weeks. In addition, CDI incidence surveillance was performed on all new CDI cases over a 13-week period. Cases were assessed for CDI risk factors, disease severity, response to treatment and outcome at 6 months. RESULTS: Clostridium difficile infection prevalence was 3.5% (range 2.9-6.1%) on the medical ward and 1.1% (range 0-3.5%) on the surgical ward. Patients on the medical ward were older and more likely to be colonised with MRSA; however, recent antibiotic use was more prevalent among surgical patients. Sixty-one new CDI cases were audited. Patients were elderly (mean age 71 years) with significant co-morbidity (median age adjusted Charlson co-morbidity score 5). CDI ribotypes included 027 (29 cases) 078 (5) and 106 (4). Eight patients developed severe CDI, seven due to 027. Antibiotic use was common with 56% receiving three or more antibiotics in the preceding 8 weeks. Twenty-four patients had died at 6 months, five due to CDI. CONCLUSION: Clostridium difficile infection prevalence gives a broad overview of CDI and points to areas that require more detailed surveillance and requires little time. However, patient-based CDI incidence surveillance provides a more useful analysis of CDI risk factors, disease and outcome for planning preventative programmes and focusing antibiotic stewardship efforts.en_GB
dc.languageENG-
dc.language.isoenen
dc.rightsArchived with thanks to Irish journal of medical scienceen_GB
dc.titleMonitoring Clostridium difficile infection in an acute hospital: prevalence or incidence studies?en_GB
dc.typeArticleen
dc.contributor.departmentDepartment of Surgery, Beaumont Hospital, Smurfit Building, Dublin 9, Ireland, amandalavan@gmail.com.en_GB
dc.identifier.journalIrish journal of medical scienceen_GB
dc.description.provinceLeinsteren

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