Impact of an intervention to control Clostridium difficile infection on hospital- and community-onset disease; an interrupted time series analysis

Clinical Microbiology and Infection

Volumn 16, Issue 8, 2010, Pages 1297-1302

  Price, J ^a   Cheek, E ^b   Lippett, S ^a   Cubbon, M ^a   Gerding, D N ^c   Sambol, S P ^c   Citron, D M ^d   Llewelyn, M ^a,e  

^a UK   (United Kingdom)

^b UNIVERSITY OF BRIGHTON   (United Kingdom)

^c LOYOLA UNIVERSITY CHICAGO   (United States)

^d RM Alden Laboratory ^*  (United States)

^e BRIGHTON AND SUSSEX MEDICAL SCHOOL   (United Kingdom)

Author keywords

Antibiotic policy; Clostridium difficile; Infection control

Indexed keywords

AMINOPENICILLIN; CARBAPENEM; CEPHALOSPORIN; DOXYCYCLINE; PENICILLIN G; QUINOLINE DERIVED ANTIINFECTIVE AGENT; ANTIINFECTIVE AGENT; CARBAPENEM DERIVATIVE; CEPHALOSPORIN DERIVATIVE; QUINOLONE DERIVATIVE;

ANTIBIOTIC THERAPY; ARTICLE; BACTERIAL STRAIN; CLOSTRIDIUM DIFFICILE; CLOSTRIDIUM DIFFICILE INFECTION; COMMUNICABLE DISEASE; COMMUNITY CARE; CONTROLLED STUDY; DISEASE COURSE; DRUG EFFICACY; DRUG USE; HEALTH CARE POLICY; HOSPITAL INFECTION; HUMAN; INFECTION CONTROL; LENGTH OF STAY; MAJOR CLINICAL STUDY; NONHUMAN; PRIORITY JOURNAL; TEACHING HOSPITAL; TIME SERIES ANALYSIS; TREATMENT OUTCOME; CLOSTRIDIUM INFECTIONS; COMMUNITY-ACQUIRED INFECTIONS; CROSS INFECTION; DRUG UTILIZATION; HEALTH SERVICES RESEARCH; HOSPITAL; INTERVENTION STUDY; ISOLATION AND PURIFICATION; PEPTOCLOSTRIDIUM DIFFICILE; POLICY; PREVALENCE; PROCEDURES; TRENDS;

ANTI-BACTERIAL AGENTS; CARBAPENEMS; CEPHALOSPORINS; CLOSTRIDIUM DIFFICILE; CLOSTRIDIUM INFECTIONS; COMMUNITY-ACQUIRED INFECTIONS; CROSS INFECTION; DOXYCYCLINE; DRUG UTILIZATION; HEALTH SERVICES RESEARCH; HOSPITALS; HUMANS; INFECTION CONTROL; INTERVENTION STUDIES; ORGANIZATIONAL POLICY; PREVALENCE; QUINOLONES;

EID: 77955147810     PISSN: 1198743X     EISSN: 14690691     Source Type: Journal    
DOI: 10.1111/j.1469-0691.2009.03077.x     Document Type: Article

References (17)

1. Loo VG, Poirier L, Miller MA. A predominantly clonal multi-institutional outbreak of Clostridium difficile-associated diarrhea with high morbidity and mortality. N Engl J Med 2005, 353:2442-2449.
2. Pepin J, Valiquette L, Alary ME. Clostridium difficile-associated diarrhea in a region of Quebec from 1991 to 2003: a changing pattern of disease severity. CMAJ 2004, 171:466-472.
3. Kuijper EJ, van Dissel JT, Wilcox MH. Clostridium difficile: changing epidemiology and new treatment options. Curr Opin Infect Dis 2007, 20:376-383.
4. Zilberberg MD, Shorr AF, Kollef MH. Increase in adult Clostridium difficile-related hospitalizations and case-fatality rate, United States, 2000-2005. Emerg Infect Dis 2008, 14:929-931.
5. McDonald LC, Killgore GE, Thompson A. An epidemic, toxin gene-variant strain of Clostridium difficile. N Engl J Med 2005, 353:2433-2441.
6. Kyne L, Sougioultzis S, McFarland LV, Kelly CP. Underlying disease severity as a major risk factor for nosocomial Clostridium difficile diarrhea. Infect Control Hosp Epidemiol 2002, 23:653-659.
7. Razavi B, Apisarnthanarak A, Mundy LM. Clostridium difficile: emergence of hypervirulence and fluoroquinolone resistance. Infection 2007, 35:300-307.
8. Dubberke ER, Reske KA, Yan Y, Olsen MA, McDonald LC, Fraser VJ. Clostridium difficile- associated disease in a setting of endemicity: identification of novel risk factors. Clin Infect Dis 2007, 45:1543-1549.
9. Clostridium difficile infection: how to deal with the problem. 2009http://doh.gov.uk, http://hpa.org.uk, [cited 2009 July 24] Health Protection Agency. Available at:
10. Dubberke ER, Gerding DN, Classen D. Strategies to prevent clostridium difficile infections in acute care hospitals. Infect Control Hosp Epidemiol 2008, 29(suppl 1):S81-S92.
11. Killgore G, Thompson A, Johnson S. Comparison of seven techniques for typing International epidemic strains of Clostridium difficile: restriction endonuclease analysis, pulsed-field gel electrophoresis, PCR-ribotyping, multilocus sequence typing, multilocus variable-number tandem-repeat analysis, amplified fragment length polymorphism, and surface layer protein A gene sequence typing. J Clin Microbiol 2008, 46:431-437.
12. Stone SP, Cooper BS, Kibbler CC. The ORION statement: guidelines for transparent reporting of outbreak reports and intervention studies of nosocomial infection. Lancet Infect Dis 2007, 7:282-288.
13. Muto CA, Blank MK, Marsh JW. Control of an outbreak of infection with the hypervirulent Clostridium difficile BI strain in a university hospital using a comprehensive "bundle" approach. Clin Infect Dis 2007, 10:1266-1273.
14. Valiquette L, Cossette B, Garant MP, Diab H, Pepin J. Impact of a reduction in the use of high-risk antibiotics on the course of an epidemic of Clostridium difficile-associated disease caused by the hypervirulent NAP1/027 strain. Clin Infect Dis 2007, 2:S112-S121.
15. Debast SB, Vaessen N, Choudry A, Wiegers-Ligtvoet EA, van den Berg RJ, Kuijper EJ. Successful combat of an outbreak due to Clostridium difficile PCR ribotype 027 and recognition of specific risk factors. Clin Microbiol Infect 2009, 15:427-434.
16. Brazier JS, Raybould R, Patel B. Distribution and antimicrobial susceptibility patterns of Clostridium difficile PCR ribotypes in English hospitals, 2007-08. Euro Surveill 2008, 9:13.
17. Fowler S, Webber A, Cooper BS. Successful use of feedback to improve antibiotic prescribing and reduce Clostridium difficile infection: a controlled interrupted time series. J Antimicrob Chemother 2007, 59:990-995.