Are Patients with Prior Clostridium difficile Infection (CDI) a Potential Source of Transmission during Hospital Admissions?

نویسندگان

  • Melany Gonzalez-Orta
  • Carlos Saldana
  • Jennifer Cadnum
  • Curtis J Donskey
چکیده

set included WCC (< 4, 12–19.9, or ≥20 × 10/L), BUN≥11 mmol/L, serum albumin <25 g/L, heart rate > 90/minute, and respiratory rate >20/minute. A predictive score of min 0 and max 13 points was derived. A score ≥7 points was associated with 70% cases of cCDI, showed 68% sensitivity (95% CI, 55–80) in the derivation set and 70% (51–88) in the validation set, a specificity of 73% (69–76) and 76% (72–81) respectively, 17% PPV (9–25), and 97% NPV (95–99) in both sets. Conclusion. Using a large multicenter prospective cohort and robust modeling approach, we derived a predictive score that included easily available measures at the bedside. The score showed acceptable performance. Further validation is needed on cohorts with different characterstics (non-outbreak setting, higher rate of cCDI). Other approaches such as combination of biomarkers could be more predictive of cCDI. Disclosures. J. Powis, Merck: Grant Investigator, Research grant; GSK: Grant Investigator, Research grant; Roche: Grant Investigator, Research grant; Synthetic Biologicals: Investigator, Research grant

برای دانلود رایگان متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Isolation of C. difficile Carriers Alone and as Part of a Bundle Approach for the Prevention of Clostridium difficile Infection (CDI): A Mathematical Model Based on Clinical Study Data

Clostridium difficile infection is the most common hospital-acquired infection. Besides infected patients, carriers have emerged as a key player in C. difficile epidemiology. In this study, we evaluated the impact of identifying and isolating carriers upon hospital admission on the incidence of CDI incidence and hospital-acquired C. difficile colonization, as a single policy and as part of bund...

متن کامل

Assessment of administrative data for evaluating the shifting acquisition of Clostridium difficile infection in England.

BACKGROUND Little is known about the acquisition of Clostridium difficile infection (CDI) and whether it represents hospital- or community-acquired infection. AIM To test the feasibility and value of using national hospital admissions data from Hospital Episode Statistics to examine trends in CDI in England. METHODS Hospital Episode Statistics from the period 1997/98 to 2009/10 were used. T...

متن کامل

Effectiveness of screening hospital admissions to detect asymptomatic carriers of Clostridium difficile: a modeling evaluation.

OBJECTIVE Both asymptomatic and symptomatic Clostridium difficile carriers contribute to new colonizations and infections within a hospital, but current control strategies focus only on preventing transmission from symptomatic carriers. Our objective was to evaluate the potential effectiveness of methods targeting asymptomatic carriers to control C. difficile colonization and infection (CDI) ra...

متن کامل

Clostridium difficile Infections amongst Patients with Haematological Malignancies: A Data Linkage Study

OBJECTIVES Identify risk factors for Clostridium difficile infection (CDI) and assess CDI outcomes among Australian patients with a haematological malignancy. METHODS A retrospective cohort study involving all patients admitted to hospitals in Western Australia with a haematological malignancy from July 2011 to June 2012. Hospital admission data were linked with all hospital investigated CDI ...

متن کامل

Antibiotic Overuse is a Major Risk Factor for Clostridium difficile Infection in Surgical Patients.

Clostridium difficile infection (CDI) is associated with increased cost, morbidity, and mortality in postoperative patients. Variable rates of postoperative CDI are reported among 4 surgical specialties during the 30-month study period. Risk factors for CDI include antibiotic use, increased ASA score, and increased admissions in the past year. Infect Control Hosp Epidemiol 2017;38:1254-1257.

متن کامل

تایپینگ مولکولی سویه‌های کلستریدیوم دیفیسیل جدا شده از بیماران بستری به روش PCR-Ribotyping

Abstract Background: Clostridium difficile infection (CDI) has been a major growing problem in hospitals in recent years. Detection of the source of Clostridium difficile strains is of importance for the control of the nosocomial spread of this microorganism. This study was done to identify C.difficile isolates by polymerase chain reaction, (PCR), ribotyping. Materials and methods: The descript...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

عنوان ژورنال:

دوره 4  شماره 

صفحات  -

تاریخ انتشار 2017