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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Antibiotics (5)
- Antimicrobial Stewardship (2)
- Cancer (1)
- Catheter-Associated Urinary Tract Infection (CAUTI) (1)
- Central Line-Associated Bloodstream Infections (CLABSI) (1)
- (-) Clostridium difficile Infections (23)
- Community-Acquired Infections (1)
- Comparative Effectiveness (1)
- Data (1)
- Diagnostic Safety and Quality (1)
- Education: Continuing Medical Education (1)
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- Healthcare-Associated Infections (HAIs) (19)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Hospitals (4)
- Infectious Diseases (5)
- Inpatient Care (1)
- Medicare (1)
- Medication (2)
- Medication: Safety (1)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (3)
- Nursing Homes (1)
- Patient Safety (9)
- Policy (1)
- Practice Patterns (1)
- Prevention (7)
- Provider (1)
- Public Health (1)
- Risk (4)
- Surgery (1)
- Treatments (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 23 of 23 Research Studies DisplayedSchoyer E, Hall K
Environmental cleaning and decontamination to prevent clostridioides difficile infection in health care settings: a systematic review.
The aim of this systematic review was to examine the most effective and feasible methods for environmental cleaning and decontamination to prevent Clostridioides difficile infection (CDI) in health care settings. The investigators concluded that the studied practices for environmental cleaning and decontamination were associated with significant decreases in facility-level CDI rates in most of the reviewed studies; however, study quality was low.
AHRQ-funded; 233201500013I.
Citation: Schoyer E, Hall K .
Environmental cleaning and decontamination to prevent clostridioides difficile infection in health care settings: a systematic review.
J Patient Saf 2020 Sep;16(3S Suppl 1):S12-s15. doi: 10.1097/pts.0000000000000749..
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Infectious Diseases, Prevention, Patient Safety
Song J, Cohen B, Zachariah P
Temporal change of risk factors in hospital-acquired Clostridioides difficile infection using time-trend analysis.
Given recent changes in the epidemiology of Clostridioides difficile infection (CDI) and prevention efforts, the authors investigated temporal changes over a period of 11 years (2006-2016) in incidence and risk factors for CDI using a retrospective matched case-control study design. The investigators concluded that although the incidence of HA-CDI decreased over time, CA-CDI simultaneously increased.
Citation: Song J, Cohen B, Zachariah P .
Temporal change of risk factors in hospital-acquired Clostridioides difficile infection using time-trend analysis.
Infect Control Hosp Epidemiol 2020 Sep;41(9):1048-57. doi: 10.1017/ice.2020.206..
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Risk, Patient Safety
Luzum M, Sebolt J, Chopra V
Catheter-associated urinary tract infection, Clostridioides difficile colitis, central line-associated bloodstream infection, and methicillin-resistant Staphylococcus aureus.
This article provides summaries of the background, epidemiology, diagnosis, and treatment of central line-associated bloodstream infection, catheter-associated urinary tract infection, Clostridioides difficile, and methicillin-resistant Staphylococcus aureus colonization and infections. Additional prevention strategies, including those related to recent national interventions, are also reviewed.
AHRQ-funded; HS022835.
Citation: Luzum M, Sebolt J, Chopra V .
Catheter-associated urinary tract infection, Clostridioides difficile colitis, central line-associated bloodstream infection, and methicillin-resistant Staphylococcus aureus.
Med Clin North Am 2020 Jul;104(4):663-79. doi: 10.1016/j.mcna.2020.02.004..
Keywords: Catheter-Associated Urinary Tract Infection (CAUTI), Urinary Tract Infection (UTI), Clostridium difficile Infections, Methicillin-Resistant Staphylococcus aureus (MRSA), Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Infectious Diseases
Ilies I, Benneyan JC, Jabur TBC
Impact of molecular testing on reported Clostridoides difficile infection rates.
This study examined the impact of changing from the enzyme immunoassay (EIA) method to nucleic acid amplification tests (NAATs) to detect incidence of Cloistridoides difficile infection (CDI) in hospitals. The authors analyzed retrospective data from 2009-2017 from 47 hospitals in the southeastern United States. During that time period 37 hospitals switched to NAAT, including 24 with good pre- and post-switch data for statistical analysis. The incidence of CDI detection did go up in hospitals that had transitioned from 10.9 to 23.9 per 10,000 patient days, an average increase of 75%.
AHRQ-funded; HS023821.
Citation: Ilies I, Benneyan JC, Jabur TBC .
Impact of molecular testing on reported Clostridoides difficile infection rates.
Infect Control Hosp Epidemiol 2020 Mar;41(3):306-12. doi: 10.1017/ice.2019.327..
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Patient Safety, Hospitals
McHaney-Lindstrom M, Hebert C, Miller H
Network analysis of intra-hospital transfers and hospital onset Clostridium difficile infection.
This paper explores how social network analysis (SNA) software can be used to analyze intra-hospital networks of individuals with a healthcare associated infection (HAI) for further analysis in a GIS environment. The SNA analysis compared cases to controls which highlighted significant differences in the overall structure of the networks.
AHRQ-funded; HS024379.
Citation: McHaney-Lindstrom M, Hebert C, Miller H .
Network analysis of intra-hospital transfers and hospital onset Clostridium difficile infection.
Health Info Libr J 2020 Mar;37(1):26-34. doi: 10.1111/hir.12274..
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Infectious Diseases, Hospitals, Public Health
Bowman JA, Utter GH
Evolving strategies to manage Clostridium difficile colitis.
The authors discuss Clostridium difficile infection and diagnostic methods and treatment strategies evolved in recent years. They indicate that oral or enteral vancomycin is now preferred for first-line antimicrobial treatment across the disease spectrum, including mild to moderate initial cases. Further, fidaxomicin, bezlotoxumab, and fecal microbiota transplantation expand the therapeutic armamentarium, with operative treatment being reserved for patients with fulminant infection. They add that early identification of patients who would benefit from an operation remains a challenge.
AHRQ-funded; HS022236.5rf2c
Citation: Bowman JA, Utter GH .
Evolving strategies to manage Clostridium difficile colitis.
J Gastrointest Surg 2020 Feb;24(2):484-91. doi: 10.1007/s11605-019-04478-5..
Keywords: Clostridium difficile Infections, Infectious Diseases, Healthcare-Associated Infections (HAIs), Antibiotics, Medication, Treatments
Jump RLP, Gaur S, Katz MJ
Template for an antibiotic stewardship policy for post-acute and long-term care settings.
To support compliance with Centers for Medicare and Medicaid services (CMS) requirements and aid facilities in establishing a stewardship program, the Infection Advisory Committee at the American Medical Directors Association -The Society for Post-Acute and Long-Term Care Medicine, has developed an antibiotic stewardship policy template tailored to the long-term care setting. This paper describes that policy template.
AHRQ-funded; HS022465; HS023779.
Citation: Jump RLP, Gaur S, Katz MJ .
Template for an antibiotic stewardship policy for post-acute and long-term care settings.
J Am Med Dir Assoc 2017 Nov;18(11):913-20. doi: 10.1016/j.jamda.2017.07.018..
Keywords: Antibiotics, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Policy, Prevention
Roghmann MC, Andronescu LR, Stucke EM
Clostridium difficile colonization of nursing home residents.
This letter to the editor notes that Clostridum difficile is a leading cause of infectious diarrhea in nursing homes and asserts that evidence-based infection control guidelines are needed to reduce transmission of C. difficile in these settings.
AHRQ-funded; HS019979.
Citation: Roghmann MC, Andronescu LR, Stucke EM .
Clostridium difficile colonization of nursing home residents.
Infect Control Hosp Epidemiol 2017 Oct;38(10):1267-68. doi: 10.1017/ice.2017.172..
Keywords: Clostridium difficile Infections, Evidence-Based Practice, Guidelines, Nursing Homes
Barker AK, Zellmer C, Tischendorf J
On the hands of patients with Clostridium difficile: a study of spore prevalence and the effect of hand hygiene on C difficile removal.
This study assessed the prevalence of Clostridium difficile spores in 48 observations of infected inpatients after randomly assigning them to hand hygiene with either alcohol-based handrub or soap and water.
AHRQ-funded; HS023791.
Citation: Barker AK, Zellmer C, Tischendorf J .
On the hands of patients with Clostridium difficile: a study of spore prevalence and the effect of hand hygiene on C difficile removal.
Am J Infect Control 2017 Oct;45(10):1154-56. doi: 10.1016/j.ajic.2017.03.005..
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Patient Safety, Prevention
Ferrada P, Callcut R, Zielinski MD
Loop ileostomy versus total colectomy as surgical treatment for Clostridium difficile-associated disease: an Eastern Association for the Surgery of Trauma multicenter trial.
The objective of this study was to compare loop ileostomy (LI) and total colectomy (TC) procedures in a multicentric approach to help the surgeon decide what procedure was best suited for the patient in need. In this study, the investigators found that LI carried less mortality than TC.
AHRQ-funded; HS024547.
Citation: Ferrada P, Callcut R, Zielinski MD .
Loop ileostomy versus total colectomy as surgical treatment for Clostridium difficile-associated disease: an Eastern Association for the Surgery of Trauma multicenter trial.
J Trauma Acute Care Surg 2017 Jul;83(1):36-40. doi: 10.1097/ta.0000000000001498..
Keywords: Clostridium difficile Infections, Comparative Effectiveness, Infectious Diseases, Surgery, Treatments
Cannon CM, Musuuza JS, Barker AK
Risk of Clostridium difficile infection in hematology-oncology patients colonized with toxigenic C. difficile.
This study determined that the prevalence of colonization with toxigenic Clostridium difficile among patients with hematological malignancies and/or bone marrow transplant at admission to a 566-bed academic medical care center was 9.3 percent. Thirteen percent of colonized patients developed symptomatic disease during hospitalization. This population may benefit from targeted C. difficile infection control interventions.
AHRQ-funded; HS024039; HS023791.
Citation: Cannon CM, Musuuza JS, Barker AK .
Risk of Clostridium difficile infection in hematology-oncology patients colonized with toxigenic C. difficile.
Infect Control Hosp Epidemiol 2017 Jun;38(6):718-20. doi: 10.1017/ice.2017.48.
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Keywords: Cancer, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Patient Safety, Risk
Seidelman J, Dicks KV, Durkin MJ
Using clinical scenarios to understand preventability of Clostridium difficile infections by inpatient antibiotic stewardship programs.
The authors of this research brief designed a 2-phase study (1) to define the types of clostridium difficile infections (CDI) that clinicians consider unlikely preventable by inpatient antibiotic stewardship programs and (2) to estimate the relative proportion of inpatient CDI cases at a tertiary-care hospital that belongs to this category of “nonpreventable” CDI.
AHRQ-funded; HS023866.
Citation: Seidelman J, Dicks KV, Durkin MJ .
Using clinical scenarios to understand preventability of Clostridium difficile infections by inpatient antibiotic stewardship programs.
Infect Control Hosp Epidemiol 2017 Jun;38(6):747-49. doi: 10.1017/ice.2017.32..
Keywords: Antibiotics, Antimicrobial Stewardship, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Healthcare-Associated Infections (HAIs), Inpatient Care
Anderson DJ, Rojas LF, Watson S
Identification of novel risk factors for community-acquired Clostridium difficile infection using spatial statistics and geographic information system analyses.
The rate of community-acquired Clostridium difficile infection (CA-CDI) is increasing. While receipt of antibiotics remains an important risk factor for CDI, studies related to acquisition of C. difficile outside of hospitals are lacking. This study found that proximity to a livestock farm (0.01), proximity to farming raw materials services (0.02), and proximity to a nursing home (0.04) were independently associated with increased rates of CA-CDI.
AHRQ-funded; HS023866.
Citation: Anderson DJ, Rojas LF, Watson S .
Identification of novel risk factors for community-acquired Clostridium difficile infection using spatial statistics and geographic information system analyses.
PLoS One 2017 May 16;12(5):e0176285. doi: 10.1371/journal.pone.0176285.
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Keywords: Clostridium difficile Infections, Community-Acquired Infections, Risk, Patient Safety
Deshpande A, Cadnum JL, Fertelli D
Are hospital floors an underappreciated reservoir for transmission of health care-associated pathogens?
In a survey of 5 hospitals, the researchers found that floors in patient rooms were frequently contaminated with pathogens and high-touch objects such as blood pressure cuffs and call buttons were often in contact with the floor. Contact with objects on floors frequently resulted in transfer of pathogens to hands.
AHRQ-funded; HS020004.
Citation: Deshpande A, Cadnum JL, Fertelli D .
Are hospital floors an underappreciated reservoir for transmission of health care-associated pathogens?
Am J Infect Control 2017 Mar;45(3):336-38. doi: 10.1016/j.ajic.2016.11.005.
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Keywords: Hospitals, Healthcare-Associated Infections (HAIs), Clostridium difficile Infections, Methicillin-Resistant Staphylococcus aureus (MRSA), Prevention, Patient Safety
Anderson DJ, Chen LF, Weber DJ
Enhanced terminal room disinfection and acquisition and infection caused by multidrug-resistant organisms and Clostridium difficile (the Benefits of Enhanced Terminal Room Disinfection study): a cluster-randomised, multicentre, crossover study.
The researchers determined the effects of three enhanced strategies for terminal room disinfection (disinfection of a room between occupying patients) on acquisition and infection due to methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, C difficile, and multidrug-resistant Acinetobacter. They found that the incidence of target organisms among exposed patients was significantly lower after adding UV (quaternary ammonium disinfectant and disinfecting ultraviolet [UV-C]) light to standard cleaning strategies.
AHRQ-funded; HS023866.
Citation: Anderson DJ, Chen LF, Weber DJ .
Enhanced terminal room disinfection and acquisition and infection caused by multidrug-resistant organisms and Clostridium difficile (the Benefits of Enhanced Terminal Room Disinfection study): a cluster-randomised, multicentre, crossover study.
Lancet 2017 Feb 25;389(10071):805-14. doi: 10.1016/s0140-6736(16)31588-4.
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Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Hospitals, Methicillin-Resistant Staphylococcus aureus (MRSA), Prevention, Patient Safety
Ruis AR, Shaffer DW, Shirley DK
Teaching health care workers to adopt a systems perspective for improved control and prevention of health care-associated infections.
The authors argue that procedural approaches alone, even with high levels of adherence, are often insufficient to solve the growing problem of health care-associated infections (HAIs); it is equally important that interventions address the more complex cognitive aspects of HAI control and prevention. Health care workers (HCWs) face many patient care situations for which standard procedures have not been and cannot be developed.
AHRQ-funded; HS023791.
Citation: Ruis AR, Shaffer DW, Shirley DK .
Teaching health care workers to adopt a systems perspective for improved control and prevention of health care-associated infections.
Am J Infect Control 2016 Nov;44(11):1360-64. doi: 10.1016/j.ajic.2016.04.211.
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Keywords: Clostridium difficile Infections, Education: Continuing Medical Education, Healthcare-Associated Infections (HAIs), Prevention, Provider
Olsen MA, Young-Xu Y, Stwalley D
The burden of Clostridium difficile infection: estimates of the incidence of CDI from U.S. administrative databases.
The researchers used comparable methods with multiple administrative databases to compare the incidence of clostridium difficile infection (CDI) in older and younger persons in the United States. They found that the incidence of CDI was 10-fold lower and the proportion of community-onset CDI was much higher in the privately insured younger LabRx population compared to the elderly Medicare population.
AHRQ-funded; HS019455.
Citation: Olsen MA, Young-Xu Y, Stwalley D .
The burden of Clostridium difficile infection: estimates of the incidence of CDI from U.S. administrative databases.
BMC Infect Dis 2016 Apr 22;16:177. doi: 10.1186/s12879-016-1501-7.
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Keywords: Healthcare Cost and Utilization Project (HCUP), Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Data, Prevention
Croft L, Ladd J, Doll M
Inappropriate antibiotic use and gastric acid suppression preceding Clostridium difficile infection.
To understand how often Clostridium difficile infection (CDI) is related to inappropriate medication use, the researchers evaluated appropriateness of antimicrobial therapy and gastric acid suppression preceding CDI acquired. Of all CDI episodes, 38.0 percent (27 of 71) were preceded by inappropriate gastric acid suppressant medications. For the 40 episodes in which gastric acid suppressant medications were used prior to CDI, 27 (67.5 percent) were inappropriately treated.
AHRQ-funded; HS018111.
Citation: Croft L, Ladd J, Doll M .
Inappropriate antibiotic use and gastric acid suppression preceding Clostridium difficile infection.
Infect Control Hosp Epidemiol 2016 Apr;37(4):494-5. doi: 10.1017/ice.2016.2.
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Keywords: Adverse Drug Events (ADE), Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Medication: Safety, Medication
Dubberke ER, Olsen MA, Stwalley D
Identification of Medicare recipients at highest risk for Clostridium difficile infection in the US by population attributable risk analysis.
This study determined the population attributable risk percent (PAR%) for Clostridium difficile infection (CDI) in various subpopulations in the Medicare 5% random sample. It found that small and identifiable subpopulations that account for relatively large proportions of CDI cases in the elderly were identified. These data can be used to target specific subpopulations for CDI prevention interventions.
AHRQ-funded; HS019455.
Citation: Dubberke ER, Olsen MA, Stwalley D .
Identification of Medicare recipients at highest risk for Clostridium difficile infection in the US by population attributable risk analysis.
PLoS One 2016 Feb 9;11(2):e0146822. doi: 10.1371/journal.pone.0146822.
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Keywords: Medicare, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Risk
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