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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (1)
- Antibiotics (3)
- Antimicrobial Stewardship (1)
- Cancer (1)
- (-) Clostridium difficile Infections (13)
- Community-Acquired Infections (1)
- Comparative Effectiveness (1)
- Evidence-Based Practice (1)
- Guidelines (1)
- Healthcare-Associated Infections (HAIs) (8)
- Hospitals (2)
- Infectious Diseases (2)
- Inpatient Care (1)
- Long-Term Care (1)
- Medication (1)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (2)
- Nursing Homes (2)
- Patient Safety (6)
- Policy (1)
- Prevention (6)
- Risk (2)
- Surgery (1)
- Treatments (1)
- 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 13 of 13 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
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