Clostridium difficile infection epidemiology and management: Comparison of results of a prospective study with a retrospective one in a reference teaching and research hospital in Northern Italy

G. Domeniconi, S. Serafino, M. Migone De Amicis, S. Formica, M. Lanzoni, A. Maraschini, F. Sisto, D. Consonni, M. D. Cappellini, G. Fabio, S. Castaldi

Research output: Contribution to journalArticle

Abstract

Background: Clostridium difficile-associated disease (CDAD) is the most common infectious antibiotic-associated diarrhea and is a growing health care problem. Prevention of Clostridium difficile infection focuses on clinical and epidemiologic infection control measures. Methods: Between 2008 and 2009, we conducted a retrospective study that showed an incidence of CDAD among the highest reported in the literature. Subsequently, we developed a preventive protocol that was adopted in our hospital in 2010. We then conducted a prospective study to investigate prevalence, incidence, and mortality of CDAD and to compare the results with those of the retrospective study, evaluating adherence to preventive measures and their efficacy. Results: In both studies, prevalence and incidence significantly increased in older patients. Crude prevalence was similar in the 2 studies. The incidence rate increased by 36%, with a significant increase only in the C and D wards. In-hospital mortality rose in both prevalent and incident cases. Regarding adhesion to hospital protocol, 77% of prevalent cases were treated with the required procedure. The highest percentage of isolated patients was achieved in C and D wards. In these wards we detected lower training hours per nurse. However, in 2013, we observed a significant decrease in incidence of CDAD and found a hospital prevalence of 0.33%. Conclusions: Health care personnel education could be more important than the possibility of isolating infected patients in single rooms.

Original languageEnglish
Pages (from-to)1214-1218
JournalAmerican Journal of Infection Control
DOIs
Publication statusPublished - 2016

Fingerprint

Clostridium Infections
Clostridium difficile
Teaching Hospitals
Italy
Epidemiology
Prospective Studies
Research
Incidence
Retrospective Studies
Delivery of Health Care
Infection Control
Hospital Mortality
Health Personnel
Diarrhea
Cohort Studies
Cross-Sectional Studies
Nurses
Anti-Bacterial Agents
Education
Mortality

Keywords

  • Clostridium difficile infection
  • Epidemiology
  • Management

ASJC Scopus subject areas

  • Infectious Diseases
  • Public Health, Environmental and Occupational Health
  • Epidemiology
  • Health Policy

Cite this

Clostridium difficile infection epidemiology and management : Comparison of results of a prospective study with a retrospective one in a reference teaching and research hospital in Northern Italy. / Domeniconi, G.; Serafino, S.; Migone De Amicis, M.; Formica, S.; Lanzoni, M.; Maraschini, A.; Sisto, F.; Consonni, D.; Cappellini, M. D.; Fabio, G.; Castaldi, S.

In: American Journal of Infection Control, 2016, p. 1214-1218.

Research output: Contribution to journalArticle

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abstract = "Background: Clostridium difficile-associated disease (CDAD) is the most common infectious antibiotic-associated diarrhea and is a growing health care problem. Prevention of Clostridium difficile infection focuses on clinical and epidemiologic infection control measures. Methods: Between 2008 and 2009, we conducted a retrospective study that showed an incidence of CDAD among the highest reported in the literature. Subsequently, we developed a preventive protocol that was adopted in our hospital in 2010. We then conducted a prospective study to investigate prevalence, incidence, and mortality of CDAD and to compare the results with those of the retrospective study, evaluating adherence to preventive measures and their efficacy. Results: In both studies, prevalence and incidence significantly increased in older patients. Crude prevalence was similar in the 2 studies. The incidence rate increased by 36{\%}, with a significant increase only in the C and D wards. In-hospital mortality rose in both prevalent and incident cases. Regarding adhesion to hospital protocol, 77{\%} of prevalent cases were treated with the required procedure. The highest percentage of isolated patients was achieved in C and D wards. In these wards we detected lower training hours per nurse. However, in 2013, we observed a significant decrease in incidence of CDAD and found a hospital prevalence of 0.33{\%}. Conclusions: Health care personnel education could be more important than the possibility of isolating infected patients in single rooms.",
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