Effects of control interventions on Clostridium difficile infection in England: an observational study
Kate E. Dingle,Kate E. Dingle,Kate E. Dingle,Xavier Didelot,T Phuong Quan,T Phuong Quan,T Phuong Quan,David W Eyre,David W Eyre,Nicole Stoesser,Nicole Stoesser,Tanya Golubchik,Tanya Golubchik,Rosalind M. Harding,Rosalind M. Harding,Daniel J. Wilson,Daniel J. Wilson,Daniel J. Wilson,David Griffiths,David Griffiths,Alison Vaughan,Alison Vaughan,John Finney,John Finney,David H. Wyllie,David H. Wyllie,David H. Wyllie,Sarah Oakley,Warren N. Fawley,Jane Freeman,K. Morris,Jessica Martin,Philip Howard,Sherwood L. Gorbach,Sherwood L. Gorbach,Ellie J. C. Goldstein,Diane M. Citron,Susan Hopkins,Susan Hopkins,Russell Hope,Alan P. Johnson,Alan P. Johnson,Mark H. Wilcox,Tim E. A. Peto,Tim E. A. Peto,Tim E. A. Peto,A. Sarah Walker,A. Sarah Walker,A. Sarah Walker,Derrick W. Crook,Derrick W. Crook,Derrick W. Crook,Carlos del Ojo Elias,Charles Crichton,Vasiliki Kostiou,Adam Giess,Jim Davies +56 more
Reads0
Chats0
TLDR
Limiting fluoroquinolone prescribing appears to explain the decline in incidence of C difficile infections, above other measures, in Oxfordshire and Leeds, England.Abstract:
Summary Background The control of Clostridium difficile infections is an international clinical challenge. The incidence of C difficile in England declined by roughly 80% after 2006, following the implementation of national control policies; we tested two hypotheses to investigate their role in this decline. First, if C difficile infection declines in England were driven by reductions in use of particular antibiotics, then incidence of C difficile infections caused by resistant isolates should decline faster than that caused by susceptible isolates across multiple genotypes. Second, if C difficile infection declines were driven by improvements in hospital infection control, then transmitted (secondary) cases should decline regardless of susceptibility. Methods Regional (Oxfordshire and Leeds, UK) and national data for the incidence of C difficile infections and antimicrobial prescribing data (1998–2014) were combined with whole genome sequences from 4045 national and international C difficile isolates. Genotype (multilocus sequence type) and fluoroquinolone susceptibility were determined from whole genome sequences. The incidence of C difficile infections caused by fluoroquinolone-resistant and fluoroquinolone-susceptible isolates was estimated with negative-binomial regression, overall and per genotype. Selection and transmission were investigated with phylogenetic analyses. Findings National fluoroquinolone and cephalosporin prescribing correlated highly with incidence of C difficile infections (cross-correlations >0·88), by contrast with total antibiotic prescribing (cross-correlations C difficile decline was driven by elimination of fluoroquinolone-resistant isolates (approximately 67% of Oxfordshire infections in September, 2006, falling to approximately 3% in February, 2013; annual incidence rate ratio 0·52, 95% CI 0·48–0·56 vs fluoroquinolone-susceptible isolates: 1·02, 0·97–1·08). C difficile infections caused by fluoroquinolone-resistant isolates declined in four distinct genotypes (p 0·2). Interpretation Restricting fluoroquinolone prescribing appears to explain the decline in incidence of C difficile infections, above other measures, in Oxfordshire and Leeds, England. Antimicrobial stewardship should be a central component of C difficile infection control programmes. Funding UK Clinical Research Collaboration (Medical Research Council, Wellcome Trust, National Institute for Health Research); NIHR Oxford Biomedical Research Centre; NIHR Health Protection Research Unit on Healthcare Associated Infection and Antimicrobial Resistance (Oxford University in partnership with Public Health England [PHE]), and on Modelling Methodology (Imperial College, London in partnership with PHE); and the Health Innovation Challenge Fund.read more
Citations
More filters
Journal ArticleDOI
Trends in U.S. Burden of Clostridioides difficile Infection and Outcomes.
Alice Guh,Yi Mu,Lisa G. Winston,Helen Johnston,Danyel M Olson,Monica M. Farley,Lucy E. Wilson,Stacy Holzbauer,Erin C. Phipps,Ghinwa Dumyati,Zintars G. Beldavs,Marion A. Kainer,Maria Karlsson,Dale N. Gerding,L. Clifford McDonald +14 more
TL;DR: The estimated national burden of C. difficile infection and associated hospitalizations decreased from 2011 through 2017, owing to a decline in health care-associated infections.
Journal ArticleDOI
2019 update of the WSES guidelines for management of Clostridioides (Clostridium) difficile infection in surgical patients
Massimo Sartelli,Stefano Di Bella,Lynne V. McFarland,Sahil Khanna,Luis Furuya-Kanamori,Nadir Abuzeid,Fikri M. Abu-Zidan,Luca Ansaloni,Goran Augustin,Miklosh Bala,Offir Ben-Ishay,Walter L. Biffl,Stephen M. Brecher,Adrián Camacho-Ortiz,Miguel Caínzos,Shirley Chan,Jill R. Cherry-Bukowiec,Jesse Clanton,Federico Coccolini,Maria E. Cocuz,Raul Coimbra,Francesco Cortese,Yunfeng Cui,Jacek Czepiel,Zaza Demetrashvili,Isidoro Di Carlo,Salomone Di Saverio,Irina Dumitru,Christian Eckmann,Edward H. Eiland,Joseph D. Forrester,Gustavo Pereira Fraga,Jean L. Frossard,Donald E. Fry,Donald E. Fry,Rita Galeiras,Wagih Ghnnam,Carlos Augusto Gomes,Ewen A. Griffiths,Xavier Guirao,Mohamed Hassan Ahmed,Torsten Herzog,Jae Il Kim,Tariq Iqbal,Arda Isik,Kamal M.F. Itani,Francesco M. Labricciosa,Yeong Yeh Lee,Paul Juang,Aleksandar Karamarkovic,Peter K. Kim,Yoram Kluger,Ari Leppäniemi,Varut Lohsiriwat,Gustavo M. Machain,Sanjay Marwah,John E. Mazuski,Gökhan Metan,Ernest E. Moore,Frederick A. Moore,Carlos A. Ordoñez,Leonardo Pagani,Nicola Petrosillo,Francisco Portela,Kemal Rasa,Miran Rems,Boris Sakakushev,Helmut Segovia-Lohse,Gabriele Sganga,Vishal G Shelat,Patrizia Spigaglia,Pierre Tattevin,Cristian Tranà,Libor Urbánek,Jan Ulrych,Pierluigi Viale,Gian L. Baiocchi,Fausto Catena +77 more
TL;DR: An international multidisciplinary panel of experts from the World Society of Emergency Surgery updated its guidelines for management of CDI in surgical patients according to the most recent available literature, including recent changes introduced in the management of this infection.
Journal ArticleDOI
Changes in US Outpatient Antibiotic Prescriptions From 2011-2016.
TL;DR: Outpatient antibiotic prescription rates, especially of broad-spectrum agents, have decreased in recent years, and Clinicians who prescribe to adults, including nurse practitioners and physician assistants, are important targets for antibiotic stewardship.
Journal ArticleDOI
Clostridioides difficile Infection.
Alice Guh,Preeta K. Kutty +1 more
TL;DR: Although risk for infection is much higher in hospitalized persons than in those dwelling in the community, C difficile still causes an estimated 51.9 episodes of community-associated infection per 100000 persons.
Journal ArticleDOI
Effectiveness of targeted enhanced terminal room disinfection on hospital-wide acquisition and infection with multidrug-resistant organisms and Clostridium difficile: a secondary analysis of a multicentre cluster randomised controlled trial with crossover design (BETR Disinfection)
Deverick J. Anderson,Rebekah W. Moehring,Rebekah W. Moehring,David J. Weber,Sarah S. Lewis,Luke F. Chen,J. Conrad Schwab,Paul Becherer,Michael Blocker,Patricia F Triplett,Lauren P. Knelson,Yuliya Lokhnygina,William A. Rutala,Daniel J. Sexton +13 more
TL;DR: Enhanced terminal room disinfection with UV in a targeted subset of high-risk rooms led to a decrease in hospital-wide incidence of C difficile and VRE, and is a potential strategy to reduce the risk of acquisition of multidrug-resistant organisms and C Difficile.
References
More filters
Journal ArticleDOI
Burden of Clostridium difficile Infection in the United States
Fernanda C. Lessa,Yi Mu,Wendy Bamberg,Zintars G. Beldavs,Ghinwa Dumyati,John R. Dunn,Monica M. Farley,Stacy Holzbauer,James I. Meek,Erin C Phipps,Lucy E. Wilson,Lisa G. Winston,Jessica Cohen,Brandi Limbago,Scott K. Fridkin,Dale N. Gerding,L. Clifford McDonald +16 more
TL;DR: In this article, the authors used regression models to calculate estimates of national incidence and total number of infections, first recurrences, and deaths within 30 days after the diagnosis of C. difficile infection.
Journal ArticleDOI
BIGSdb: Scalable analysis of bacterial genome variation at the population level
TL;DR: The Bacterial Isolate Genome Sequence Database (BIGSDB) represents a freely available resource that will assist the broader community in the elucidation of the structure and function of bacteria by means of a population genomics approach.
Journal ArticleDOI
A predominantly clonal multi-institutional outbreak of Clostridium difficile-associated diarrhea with high morbidity and mortality.
Vivian G. Loo,Louise Poirier,Mark A. Miller,Matthew Oughton,Michael Libman,Sophie Michaud,Anne-Marie Bourgault,Tuyen Nguyen,Charles Frenette,Mirabelle Kelly,Anne Vibien,Paul Brassard,Susan Fenn,Ken Dewar,Thomas J. Hudson,Ruth Horn,Pierre René,Yury Monczak,Andre Dascal +18 more
TL;DR: A strain of C. difficile that was resistant to fluoroquinolones and had binary toxin and a partial deletion of the tcdC gene was responsible for this outbreak ofC.difficile-associated diarrhea.
Journal ArticleDOI
Clostridium difficile Infection
TL;DR: This article reviews the pathogenesis, epidemiology, diagnosis, and treatment of this nosocomial and potentially fatal infectious diarrhea, as well as the associated risk factors.
Journal ArticleDOI
Fidaxomicin versus Vancomycin for Clostridium difficile Infection
Thomas J. Louie,Mark A. Miller,Kathleen M. Mullane,Karl Weiss,Arnold Lentnek,Yoav Golan,Sherwood L. Gorbach,Pamela Sears,Youe-Kong Shue +8 more
TL;DR: Fidaxomicin was associated with a significantly lower rate of recurrence of C. difficile infection associated with non–North American Pulsed Field type 1 strains and the adverse-event profile was similar for the two therapies.
Related Papers (5)
Burden of Clostridium difficile Infection in the United States
Implementing an Antibiotic Stewardship Program: Guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America
Tamar F. Barlam,Tamar F. Barlam,Sara E. Cosgrove,Lilian M. Abbo,Conan MacDougall,Audrey N. Schuetz,Edward Septimus,Arjun Srinivasan,Timothy H. Dellit,Yngve Falck-Ytter,Neil O. Fishman,Cindy W. Hamilton,Timothy C. Jenkins,Pamela A. Lipsett,Preeti N. Malani,Larissa S May,Gregory J. Moran,Melinda M. Neuhauser,Jason G. Newland,Christopher A. Ohl,Matthew H. Samore,Susan K. Seo,Kavita K. Trivedi +22 more