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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (1)
- Antibiotics (3)
- Antimicrobial Stewardship (1)
- (-) Clostridium difficile Infections (8)
- Diagnostic Safety and Quality (1)
- Guidelines (1)
- Healthcare-Associated Infections (HAIs) (5)
- Infectious Diseases (1)
- Long-Term Care (1)
- Medication (1)
- Nursing Homes (1)
- Patient Safety (2)
- Practice Patterns (1)
- Prevention (2)
- Urinary Tract Infection (UTI) (1)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 8 of 8 Research Studies DisplayedPerry DA, Shirley D, Micic D
External validation and comparison of Clostridioides difficile severity scoring systems.
The purpose of this study was to validate the Clostridioides difficile infection (CDI) risk scores of previously developed predictive models. The researchers conducted a retrospective study, analyzing the CDI severity scores of 3,646 patients within 4 inpatient cohorts from 3 separate sites, including the University of Chicago (2012); the University of Michigan (2010-2012 and 2016) and the University of Wisconsin (2012). The primary outcome was a composite of admission to an intensive care unit, colectomy, and/or death attributed to CDI within 30 days of receiving a positive test. The CDI severity scores were assessed and compared within and across cohorts, and compared to the guideline definitions of severe and fulminant CDI established by the Infectious Disease Society of America (IDSA). A total of 14 scores were evaluated, including 2 of the IDSA guideline definitions. The study concluded that none of the CDI severity scores showed stable predictive ability within the study scenarios, with just one-half of the scores performing equal to or better than the IDSA definitions studied.
AHRQ-funded; HS027431.
Citation: Perry DA, Shirley D, Micic D .
External validation and comparison of Clostridioides difficile severity scoring systems.
Clin Infect Dis 2022 Jun 10;74(11):2028-35. doi: 10.1093/cid/ciab737..
Keywords: Clostridium difficile Infections, Infectious Diseases
Huang J, Park GW, Jones RM
Efficacy of EPA-registered disinfectants against two human norovirus surrogates and Clostridioides difficile endospores.
This study’s goal was to determine the efficacy of a panel of nine EPA-registered disinfectants against two human norovirus (HuNoV) surrogates (feline calicivirus [FCV] and Tulane virus [TuV]) and Clostridioides difficile endospores. These products, five of which contained H2O2 (hydrogen peroxide) as the active ingredient, were tested against infectious FCV, TuV, and C. difficile endospores using two ASTM methods, a suspension and carrier test. Products containing hydrogen peroxide were the most efficacious. Of the five products containing hydrogen peroxide, no strong correlation was observed between disinfection efficacy and hydrogen peroxide concentration. Addition of 0.025% ferrous sulphate to 1% hydrogen peroxide solution improved efficacy against FCV, TuV and C. difficile.
AHRQ-funded; HS025987.
Citation: Huang J, Park GW, Jones RM .
Efficacy of EPA-registered disinfectants against two human norovirus surrogates and Clostridioides difficile endospores.
J Appl Microbiol 2022 Jun;132(6):4289-99. doi: 10.1111/jam.15524..
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Prevention, Patient Safety
Butler AM, Durkin MJ, Keller MR
Association of adverse events with antibiotic treatment for urinary tract infection.
The purpose of this study was to compare the risk of relative harms associated with different antibiotics prescribed for the treatment of uncomplicated urinary tract infection (UTI). The researchers identified 1,169,033 healthy, nonpregnant women between the ages of 18 to 44 who had an uncomplicated UTI and who initiated an oral antibiotic regimen for the treatment of common uropathogens between July 2006 and September 2015. The study found that of the two first-line treatments, the drug trimethoprim-sulfamethoxazole (versus nitrofurantoin) was associated with a higher risk of adverse drug-related events including: hypersensitivity, acute renal failure, skin rash, urticaria, abdominal pain, and nausea/ vomiting, but a similar risk of adverse possible microbiome-related events. When researchers compared non-first line drugs with nitrofurantoin, the non-first line drugs were associated with a greater risk of adverse drug events and possible microbiome-related adverse events including non-Clostridium difficile diarrhea, C. difficile infection, vaginitis/vulvovaginal candidiasis, and pneumonia. The duration of the treatment influenced the risk of possible microbiome-related adverse events. The study concluded that the risk of adverse events differs widely by both antibiotic drug and duration of regimen.
AHRQ-funded; HS019455.
Citation: Butler AM, Durkin MJ, Keller MR .
Association of adverse events with antibiotic treatment for urinary tract infection.
Clin Infect Dis 2022 Apr 28;74(8):1408-18. doi: 10.1093/cid/ciab637..
Keywords: Antibiotics, Medication, Urinary Tract Infection (UTI), Adverse Drug Events (ADE), Adverse Events, Clostridium difficile Infections
Cannon JL, Park GW, Anderson B
Hygienic monitoring in long-term care facilities using ATP, crAssphage, and human noroviruses to direct environmental surface cleaning.
Norovirus and C. difficile can be transmitted by contaminated environmental surfaces and are associated with diarrheal illnesses and deaths in long-term care (LTC) facilities. Hygienic monitoring tools such as adenosine triphosphate (ATP) bioluminescence and indicators of fecal contamination can help to identify LTC facility surfaces with cleaning deficiencies. The researchers swabbed and tested high-touch surfaces in 11 LTC facilities for contamination by norovirus, a fecal indicator virus, crAssphage, and ATP. The study found that greater than 90% of surfaces tested positive for crAssphage or failed in their ATP scores. Norovirus contamination was not detected. Handrails, equipment controls, and patient beds were 4 times more likely than other surfaces or locations to have high levels of crAssphage. Patient bed handrails and tables and chairs in patient lounges had high levels of both ATP and crAssphage.
AHRQ-funded; HS025987.
Citation: Cannon JL, Park GW, Anderson B .
Hygienic monitoring in long-term care facilities using ATP, crAssphage, and human noroviruses to direct environmental surface cleaning.
Am J Infect Control 2022 Mar; 50(3):289-94. doi: 10.1016/j.ajic.2021.11.014..
Keywords: Nursing Homes, Long-Term Care, Prevention, Healthcare-Associated Infections (HAIs), Clostridium difficile Infections
Chung P, Currie B, Guo Y
Investigation to identify a resource-efficient case-control methodology for determining antibiotics associated with Clostridium difficile infection.
This study consisted of a series of case-control studies involving two groups of patients admitted to the hospital, the first group with clostridium difficile infection (CDI), and a control group without CDI. The purpose was to determine the relationship between the use of antibiotics and the presence of CDI. A simple matching strategy was found to be an efficient and feasible compromise strategy to identify high-risk antibiotics associated with CDI.
AHRQ-funded; 290200600012I
Citation: Chung P, Currie B, Guo Y .
Investigation to identify a resource-efficient case-control methodology for determining antibiotics associated with Clostridium difficile infection.
Am J Infect Control. 2014 Oct;42(10 Suppl):S264-8. doi: 10.1016/j.ajic.2014.05.001..
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Antimicrobial Stewardship
Ostrowsky B, Ruiz R, Brown S
Lessons learned from implementing Clostridium difficile-focused antibiotic stewardship interventions.
The researchers sought to determine whether controlling the prescription of targeted antibiotics would translate to a measurable reduction in hospital-onset Clostridium difficile infection (CDI) rates. They found that decreases in target antibiotic consumption did not translate into reductions of hospital-onset CDI in this study, but many valuable lessons were learned.
AHRQ-funded; 290200600012I.
Citation: Ostrowsky B, Ruiz R, Brown S .
Lessons learned from implementing Clostridium difficile-focused antibiotic stewardship interventions.
Infect Control Hosp Epidemiol 2014 Oct;35 Suppl 3:S86-95. doi: 10.1086/677828.
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Keywords: Antibiotics, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Patient Safety
Cadnum JL, Hurless KN, Deshpande A
Sensitive and selective culture medium for detection of environmental Clostridium difficile isolates without requirement for anaerobic culture conditions.
The researchers developed a low-cost selective broth medium containing thioglycolic acid and L-cystine, termed C. difficile Brucella broth with thioglycolic acid and L-cystine (CDBB-TC), for the detection of C. difficile from environmental specimens under aerobic culture conditions. Their findings demonstrate that a broth medium containing thioglycolic acid and L-cystine provides a sensitive and selective method for the culture of C. difficile from environmental specimens without the need for anaerobic culture conditions.
AHRQ-funded; HS020004.
Citation: Cadnum JL, Hurless KN, Deshpande A .
Sensitive and selective culture medium for detection of environmental Clostridium difficile isolates without requirement for anaerobic culture conditions.
J Clin Microbiol 2014 Sep;52(9):3259-63. doi: 10.1128/jcm.00793-14..
Keywords: Clostridium difficile Infections, Diagnostic Safety and Quality
Pakyz AL, Ozcan YA
Use of data envelopment analysis to quantify opportunities for antibacterial targets for reduction of health care-associated Clostridium difficile infection.
The authors conducted a cross-sectional study using claims data from 58 hospitals to create a benchmark strategy targeting high-risk antibacterials for C difficile. Seventeen hospitals were identified as best-practice hospitals. They found that the antibacterial classes requiring the greatest percentage reduction in use in non-best-practice hospitals versus best-practice hospitals were clindamycin, β-lactam/β-lactamase combinations, and carbapenems.
AHRQ-funded; HS018578.
Citation: Pakyz AL, Ozcan YA .
Use of data envelopment analysis to quantify opportunities for antibacterial targets for reduction of health care-associated Clostridium difficile infection.
Am J Med Qual 2014 Sep-Oct;29(5):437-44. doi: 10.1177/1062860613502520.
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Keywords: Antibiotics, Clostridium difficile Infections, Guidelines, Healthcare-Associated Infections (HAIs), Practice Patterns