High Variability in Nosocomial Clostridium difficile Infection Rates Across Hospitals After Colorectal Resection

Aquina, Christopher T.; Probst, Christian; Becerra, Adan Z.; Hensley, Bradley J.; Iannuzzi, James C.; Noyes, Katia; Monson, J. R. T.; Fleming, Fergal J.

doi:10.1097/dcr.0000000000000539

Cited by 31 publications

(21 citation statements)

References 30 publications

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“…[74][75][76][77] Furthermore, diarrhea is common after colorectal surgery, 78,79 which is related to the surgical complication and the administration of prophylactic antibiotics. These therapeutic measures give rise to AAD as well as other infectious complications such as clostridium difficile infection, 16,[80][81][82][83] Prophylactic probiotics in combination with antibiotics was conducive to reduce the incidence of diarrhea with an RR of 0.51, which might be a solution to this issue.…”

Section: Implications For Clinical Practicementioning

confidence: 99%

Efficacy of prophylactic probiotics in combination with antibiotics versus antibiotics alone for colorectal surgery: A meta‐analysis of randomized controlled trials

Liu

et al. 2018

Journal of Surgical Oncology

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This meta-analysis aimed to determine whether prophylactic probiotics in combination with antibiotics are superior to antibiotics alone in the prevention of surgical site infection (SSI) after colorectal surgery. Fourteen trials involving 1524 participants were included. Compared with antibiotics alone, prophylactic probiotics in combination with antibiotics reduced the risk of SSI as well as other complications, shortened the cumulative duration of antibiotic therapy. Current evidence suggested that probiotics in combination with antibiotics could be recommended.

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Section: Implications For Clinical Practicementioning

confidence: 99%

Efficacy of prophylactic probiotics in combination with antibiotics versus antibiotics alone for colorectal surgery: A meta‐analysis of randomized controlled trials

Liu

et al. 2018

Journal of Surgical Oncology

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“…The New York State Cancer Registry (NYSCR) and Statewide Planning and Research Cooperative System (SPARCS) were utilised for this study. The NYSCR has received the highest certification from the North American Association of Central Cancer Registries, and SPARCS is an all-payer hospital discharge database that contains patient-level data on all non-Veteran Affairs hospital admissions, ambulatory surgery procedures, and emergency department visits in New York State and has been used extensively for research purposes ( Boscoe et al , 2011 ; Aquina et al , 2015a , 2015b , 2015c , 2015d ; Iannuzzi et al , 2016 ; Aquina et al , 2016b , 2016c , 2016d ). The NYSCR is linked to Vital Records and the National Death Index to provide the cause and date of death for patients.…”

Section: Methodsmentioning

confidence: 99%

The impact of age on complications, survival, and cause of death following colon cancer surgery

et al. 2017

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Background:Given scarce data regarding the relationship among age, complications, and survival beyond the 30-day postoperative period for oncology patients in the United States, this study identified age-related differences in complications and the rate and cause of 1-year mortality following colon cancer surgery.Methods:The NY State Cancer Registry and Statewide Planning and Research Cooperative System identified stage I–III colon cancer resections (2004–2011). Multivariable logistic regression and survival analyses assessed the relationship among age (<65, 65–74, ⩾75), complications, 1-year survival, and cause of death.Results:Among 24 426 patients surviving >30 days, 1-year mortality was 8.5%. Older age groups had higher complication rates, and older age and complications were independently associated with 1-year mortality (P<0.0001). Increasing age was associated with a decrease in the proportion of deaths from colon cancer with a concomitant increase in the proportion of deaths from cardiovascular disease. Older age and sepsis were independently associated with higher risk of colon cancer-specific death (65–74: HR=1.59, 95% CI=1.26–2.00; ⩾75: HR=2.57, 95% CI=2.09–3.16; sepsis: HR=2.58, 95% CI=2.13–3.11) and cardiovascular disease-specific death (65–74: HR=3.72, 95% CI=2.29–6.05; ⩾75: HR=7.02, 95% CI=4.44–11.10; sepsis: HR=2.33, 95% CI=1.81–2.99).Conclusions:Older age and sepsis are associated with higher 1-year overall, cancer-specific, and cardiovascular-specific mortality, highlighting the importance of geriatric assessment, multidisciplinary care, and cardiovascular optimisation for older patients and those with infectious complications.

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“…Ten studies [69][70][71][72][73][74][75][76][77][78] evaluated surgical patients (Table 3), and, thus, we assumed that the CDI cases were incident cases. Five studies 73,[75][76][77][78] used data from AHRQ NIS.…”

Section: Incident Cases Of CDI (36 Studies)mentioning

confidence: 99%

Incidence and Outcomes Associated WithClostridium difficileInfections

et al. 2020

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IMPORTANCE An understanding of the incidence and outcomes of Clostridium difficile infection (CDI) in the United States can inform investments in prevention and treatment interventions. OBJECTIVE To quantify the incidence of CDI and its associated hospital length of stay (LOS) in the United States using a systematic literature review and meta-analysis. DATA SOURCES MEDLINE via Ovid, Cochrane Library Databases via Wiley, Cumulative Index of Nursing and Allied Health Complete via EBSCO Information Services, Scopus, and Web of Science were searched for studies published in the United States between 2000 and 2019 that evaluated CDI and its associated LOS. STUDY SELECTION Incidence data were collected only from multicenter studies that had at least 5 sites. The LOS studies were included only if they assessed postinfection LOS or used methods accounting for time to infection using a multistate model or compared propensity score-matched patients with CDI with control patients without CDI. Long-term-care facility studies were excluded. Of the 119 full-text articles, 86 studies (72.3%) met the selection criteria. DATA EXTRACTION AND SYNTHESIS Two independent reviewers performed the data abstraction and quality assessment. Incidence data were pooled only when the denominators used the same units (eg, patient-days). These data were pooled by summing the number of hospital-onset CDI incident cases and the denominators across studies. Random-effects models were used to obtain pooled mean differences. Heterogeneity was assessed using the I 2 value. Data analysis was performed in February 2019. MAIN OUTCOMES AND MEASURES Incidence of CDI and CDI-associated hospital LOS in the United States. RESULTS When the 13 studies that evaluated incidence data in patient-days due to hospital-onset CDI were pooled, the CDI incidence rate was 8.3 cases per 10 000 patient-days. Among propensity score-matched studies (16 of 20 studies), the CDI-associated mean difference in LOS (in days) between patients with and without CDI varied from 3.0 days (95% CI, 1.44-4.63 days) to 21.6 days (95% CI, 19.29-23.90 days). CONCLUSIONS AND RELEVANCE Pooled estimates from currently available literature suggest that CDI is associated with a large burden on the health care system. However, these estimates should be interpreted with caution because higher-quality studies should be completed to guide future evaluations of CDI prevention and treatment interventions.

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High Variability in Nosocomial Clostridium difficile Infection Rates Across Hospitals After Colorectal Resection

Cited by 31 publications

References 30 publications

Efficacy of prophylactic probiotics in combination with antibiotics versus antibiotics alone for colorectal surgery: A meta‐analysis of randomized controlled trials

Efficacy of prophylactic probiotics in combination with antibiotics versus antibiotics alone for colorectal surgery: A meta‐analysis of randomized controlled trials

The impact of age on complications, survival, and cause of death following colon cancer surgery

Incidence and Outcomes Associated WithClostridium difficileInfections

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