Proposed Checklist of Hospital Interventions to Decrease the Incidence of Healthcare-Associated <i>Clostridium difficile</i> Infection

Abbett, Sarah K.; Yokoe, Deborah S.; Lipsitz, Stuart R.; Bader, Angela M.; Berry, William R.; Tamplin, Elise; Gawande, Atul A.

doi:10.1086/644757

Cited by 61 publications

(45 citation statements)

References 25 publications

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“…This study was an observational before–after study of adult patients admitted to a tertiary university-affiliated hospital during a 4-year period from January 2004 to December 2008 42. The intervention included an educational campaign, a prevention bundle, and a treatment bundle.…”

Section: Infection Control and Prevention Strategiesmentioning

confidence: 99%

Clostridium difficile outbreaks: prevention and treatment strategies

Martínez

Leffler

Kelly

2012

RMHP

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The incidence and severity of Clostridium difficile infection (CDI) have increased dramatically over the past decade. Its treatment, however, has largely remained the same with the exception of oral vancomycin use as a first-line agent in severe disease. From 1999 to 2004, 20,642 deaths were attributed to CDI in the United States, almost 7 times the rate of all other intestinal infections combined. Worldwide, several major CDI outbreaks have occurred, and many of these were associated with the NAP1 strain. This ‘epidemic’ strain has contributed to the rising incidence and mortality of CDI. The purpose of this article is to review the current management, treatment, infection control, and prevention strategies that are needed to combat this increasingly morbid disease.

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Section: Infection Control and Prevention Strategiesmentioning

confidence: 99%

Clostridium difficile outbreaks: prevention and treatment strategies

Martínez

Leffler

Kelly

2012

RMHP

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“…49 Abbett et al. 50 and Salgado et al. 51 describe the use of a C. difficile prevention bundle in their university-affiliated tertiary care facilities.…”

Section: Resultsmentioning

confidence: 99%

Assessing control bundles for Clostridium difficile : a review and mathematical model

Yakob

Riley

Paterson

et al. 2014

Emerging Microbes & Infections

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Clostridium difficile is the leading cause of infectious diarrhea in hospitalized patients. Integrating several infection control and prevention methods is a burgeoning strategy for reducing disease incidence in healthcare settings. We present an up-to-date review of the literature on ‘control bundles' used to mitigate the transmission of this pathogen. All clinical studies of control bundles reported substantial reductions in disease rates, in the order of 33%–61%. Using a biologically realistic mathematical model we then simulated the efficacy of different combinations of the most prominent control methods: stricter antimicrobial stewardship; the administering of probiotics/intestinal microbiota transplantation; and improved hygiene and sanitation. We also assessed the health gains that can be expected from reducing the average length of stay of inpatients. In terms of reducing the rates of colonization, all combinations had the potential to give rise to marked improvements. For example, halving the number of inpatients on broad-spectrum antimicrobials combined with prescribing probiotics or intestinal microbiota transplantation could cut pathogen carriage by two-thirds. However, in terms of symptomatic disease incidence reduction, antimicrobials, probiotics and intestinal microbiota transplantation proved substantially less effective. Eliminating within-ward transmission by improving sanitation and reducing average length of stay (from six to three days) yielded the most potent symptomatic infection control combination, cutting rates down from three to less than one per 1000 hospital bed days. Both the empirical and theoretical exploration of C. difficile control combinations presented in the current study highlights the potential gains that can be achieved through strategically integrated infection control.

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“…In the UK, the frequency of Table 1 Overall incidence of C difficile episodes, incidence in A-ICUs, and incidence in the remaining hospital units [19]. Previous studies have suggested the efficacy of specific infection control measures in reducing the incidence of CDI [20][21][22]. Rapid diagnosis of CDI is essential to improve patient outcome and prevent disease transmission.…”

Section: Discussionmentioning

confidence: 99%

Is Clostridium difficile infection an increasingly common severe disease in adult intensive care units? A 10-year experience

Bouza

Rodríguez‐Créixems

Alcalá

et al. 2015

Journal of Critical Care

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Proposed Checklist of Hospital Interventions to Decrease the Incidence of Healthcare-Associated Clostridium difficile Infection

Abstract: Our intervention was successful in reducing the incidence of CDI at our hospital. On the basis of our experience, we propose the use of a checklist of hospital interventions to decrease the incidence of healthcare-associated CDI.

Cited by 61 publications

References 25 publications

Clostridium difficile outbreaks: prevention and treatment strategies

Clostridium difficile outbreaks: prevention and treatment strategies

Assessing control bundles for Clostridium difficile : a review and mathematical model

Is Clostridium difficile infection an increasingly common severe disease in adult intensive care units? A 10-year experience

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