The burden of healthcare-associated Clostridium difficile infection in a non-metropolitan setting

Bond, Stuart; Boutlis, Craig S.; Yeo, W. W.; Pratt, William; Orr, Marsha; Miyakis, Spiros

doi:10.1016/j.jhin.2016.12.009

Cited by 12 publications

(8 citation statements)

References 21 publications

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“…We extracted 19 estimates from 19 studies estimating excess LOS due to Healthcare Associated (HA) CDI in high income countries ( Figure 6). [52][53][54][55][56][57][58][59][60][61][62][63][65][66][67][68][69][70][71] The HA CDI studies focus on a single infection type caused by the same organism and estimates in each statistical group were homogenous as shown by the low I 2 scores within each analysis group in Figure 6. The overall I 2 , which can be calculated by analysing studies as a single group, was very high (99.7%) and resembled I 2 scores in the BSI studies.…”

Section: Meta-analysesmentioning

confidence: 99%

Estimating excess length of stay due to healthcare-associated infections: a systematic review and meta-analysis of statistical methodology

Manoukian

Stewart

Dancer

et al. 2018

Journal of Hospital Infection

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Section: Meta-analysesmentioning

confidence: 99%

Estimating excess length of stay due to healthcare-associated infections: a systematic review and meta-analysis of statistical methodology

Manoukian

Stewart

Dancer

et al. 2018

Journal of Hospital Infection

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“…Time to resolution of infection (diarrhoea) was signifi cantly delayed if patients used antibiotics prior to the development of CDI. This is postulated due to a change in gut microbiota promoting CDI and antibiotic stewardship is recommended [1,24,25]. The most common reasons noted in our study for starting antibiotics were infective exacerbations of COPD, neutropenic sepsis and pneumonia.…”

Section: Secondary Outcomesmentioning

confidence: 72%

“…Patients developed CDI within a few days of their hospital admission and diarrhoea usually lasted for almost a week. CDI infection was associated with increased length of hospital stay [2,13,14,24].…”

Section: Secondary Outcomesmentioning

confidence: 99%

Long term outcomes of Hospital-Identified Clostridium Difficile Infection (HICDI): A retrospective cohort analysis of adult patients in a teaching hospital

R¹,

David²,

Y³

2021

Glob J Medical Clin Case Rep

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Objectives: To study long term outcomes of HICDI. Design, settings and participants: Retrospective cohort study of adult patients diagnosed with HICDI during their admission to a tertiary teaching hospital between January 1st 2012 and December 31st 2016. Main outcomes: Primary aim was to study two-year mortality outcome and it's predictors in HICDI patients. Secondary outcomes were to identify characteristics of HICDI and predictors of time to resolution of infection. Results: A total of 819 adult HICDI episodes were identifi ed. 544 episodes occurring in 466 patients were included in fi nal analysis. Single CDI episodes occurred in 409 patients, 45 patients had 2 episodes and 12 patients had greater than 2 episodes. Two-year all-cause mortality was 33% (152/409) in single CDI episodes and 61.4% (35/57) for those with more than one CDI episode. Of the 466 patients, the inhospital all-cause mortality directly attributed to CDI was 14 patients (3%). Risk factors predicting long-term mortality were, chemotherapy (AHR(adjusted hazard ratio)2.7; 95% CI 1.90-3.81;p=0.01), low albumin(AHR 2.44; 95% CI 1.83-3.47; p=0.01), ICU admission(AHR 2.09, 95% CI 1.44-3.03; p=0.01) high WBC count (AHR 1.78,CI 1.28-2.30; p=0.01), multiple CDIs (AHR 1.24,95% CI 1.09-1.39; p=0.01) and age (AHR:1.04;95%CI:1.03-1.05;p=0.01). Most common type of HICDI was Hospital-Acquired CDI (HA-CDI) (55.8 %; n=260). Antibiotic usage before developing CDI signifi cantly delayed the time to resolution of infection (AIRR: 1.35; 95% CI 1.06-1.71; p=0.01). In 1/3rd (n=180) of HICDI episodes, patients were discharged before resolution of diarrhoea. Majority of HICDI episodes (n=371) were treated with metronidazole. Conclusion: HICDI was associated with signifi cant long term mortality and morbidity. Mortality increased with more than one CDI infection. Antibiotic usage before developing CDI signifi cantly delayed the time to resolution of infection.

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“…Additionally, the burden and financial costs liable to C. difficile infection in South-America and Africa have not yet been reported in literature. Regarding Oceania, a publication from 2016 estimated the occurrence of C. difficile infection in Australia to account for approximately 12,700 cases between 2011 and 2012 [ 27 ] with a hospitalisation cost of approximately AU$ 19,000 per patient based on Bond et al (2017) [ 28 ].…”

Section: Faecal Microbiota Transplantationmentioning

confidence: 99%

Faecal microbiota transplantation: a regulatory hurdle?

Verbeke

Wynendaele

2017

BMC Gastroenterol

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During faecal microbiota transplantation, stool from a healthy donor is transplanted to treat a variety of dysbiosis-associated gut diseases. Competent authorities are faced with the challenge to provide adequate regulation. Currently, regulatory harmonization is completely lacking and authorities apply non-existing to most stringent requirements. A regulatory approach for faecal microbiota transplantation could be inserting faecal microbiota transplantation in the gene-, cell- and tissue regulations, including the hospital exemption system in the European Advanced Therapy Medicinal Products regulation, providing a pragmatic and efficacy-risk balanced approach and granting all patients as a matter of principle access to this therapy.

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The burden of healthcare-associated Clostridium difficile infection in a non-metropolitan setting

Abstract: HCA-CDI placed a significant burden on the regional and rural health service through increased LOS and hospital costs. Interventions targeting HCA-CDI could be employed to consolidate the effects of ASPs.

Cited by 12 publications

References 21 publications

Estimating excess length of stay due to healthcare-associated infections: a systematic review and meta-analysis of statistical methodology

Estimating excess length of stay due to healthcare-associated infections: a systematic review and meta-analysis of statistical methodology

Long term outcomes of Hospital-Identified Clostridium Difficile Infection (HICDI): A retrospective cohort analysis of adult patients in a teaching hospital

Faecal microbiota transplantation: a regulatory hurdle?

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