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.

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.

• Authors: 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
• Journal: American journal of infection control (Am J Infect Control) Vol. 44 Issue 11 Pg. 1214-1218 (11 01 2016) ISSN: 1527-3296 [Electronic] United States
• PMID: 27372227 (Publication Type: Journal Article)
• Copyright: Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Topics

• Aged
• Aged, 80 and over
• Attitude of Health Personnel
• Clostridioides difficile (isolation & purification)
• Clostridium Infections (epidemiology, microbiology, mortality, prevention & control)
• Cross-Sectional Studies
• Education, Medical
• Female
• Guideline Adherence
• Hospitals, Teaching
• Humans
• Incidence
• Infection Control (methods)
• Italy (epidemiology)
• Male
• Middle Aged
• Prospective Studies
• Retrospective Studies