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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.

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1 to 25 of 50 Research Studies Displayed
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..
View abstract on the National Library of Medicine site.
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..
View abstract on the National Library of Medicine site.
Keywords: Antibiotics, Medication, Urinary Tract Infection (UTI), Adverse Drug Events (ADE), Adverse Events, Clostridium difficile Infections
Alrawashdeh M, Rhee C, Hsu H
Assessment of federal value-based incentive programs and in-hospital Clostridioides difficile infection rates.
The authors sought to examine the association between value-based incentive program (VBIP) implementation and health care facility-onset Clostridioides difficile infection (HO-CDI) rates. Their study evaluated HO-CDI rates among adults hospitalized at acute-care hospitals from January 2013 to March 2019. They found that, in this study, VBIP implementation was associated with improvements in HO-CDI rates, independent of CDI testing method. They recommended that future research focus on elucidating the specific processes that contributed to improvement in HO-CDI rates to inform the design of future VBIP interventions.
AHRQ-funded; HS018414; HS025008.
Citation: Alrawashdeh M, Rhee C, Hsu H . Assessment of federal value-based incentive programs and in-hospital Clostridioides difficile infection rates. JAMA Netw Open 2021 Oct;4(10):e2132114. doi: 10.1001/jamanetworkopen.2021.32114..
View abstract on the National Library of Medicine site.
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Quality of Care
Page B, Klompas M, Chan C
Surveillance for healthcare-associated infections: hospital-onset adult sepsis events versus current reportable conditions.
US hospitals are required by the Centers for Medicare and Medicaid Services to publicly report central line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), Clostridioidesdiffficile, methicillin-resistant Staphylococcus aureus bacteremia, and selected surgical site infections for benchmarking and pay-for-performance programs. In this study the investigators retrospectively assessed the overlap between HO-ASEs and reportable HAIs among adults hospitalized between June 2015-June 2018 in 3 hospitals.
AHRQ-funded; HS025008.
Citation: Page B, Klompas M, Chan C . Surveillance for healthcare-associated infections: hospital-onset adult sepsis events versus current reportable conditions. Clin Infect Dis 2021 Sep 15;73(6):1013-19. doi: 10.1093/cid/ciab217..
View abstract on the National Library of Medicine site.
Keywords: Sepsis, Healthcare-Associated Infections (HAIs), Hospitals, Clostridium difficile Infections, Catheter-Associated Urinary Tract Infection (CAUTI), Methicillin-Resistant Staphylococcus aureus (MRSA), Central Line-Associated Bloodstream Infections (CLABSI)
Cabral SM, Goodman KE, Blanco N
Comorbidity and severity-of-illness risk adjustment for hospital-onset Clostridioides difficile infection using data from the electronic medical record.
This study’s objective was to determine whether electronically available comorbidities and laboratory values on admission are risk factors for hospital-onset Clostridioides difficile infection (HO-CDI) across multiple institutions and whether they could be used to improve risk adjustment. Adult patients admitted to 3 hospitals in Maryland from 2016 to 2018 were included. Patients with comorbid conditions were assigned using the Elixhauser comorbidity index. Standardized infection rates (SIRs) were computed using current CDC risk adjustment methodology and included the addition of Elixhauser score and individual comorbidities. Hospital 1 had 314 (0.65%) of patients with a HO-CDI, Hospital 2 had 41 (0.47%) with a HO-CDI, and Hospital 3 had 75 (0.26%) with a HO-CDI. Elixhauser score in multivariable regression was a significant risk factor for HO-CDI at all hospitals when controlling for age, antibiotic user, and antacid use. Abnormal leukocyte level at hospital admission was a significant risk factor at hospitals 1 and 2. Including the Elixhauser score in the risk adjustment model was statistically significant.
AHRQ-funded; HS022291.
Citation: Cabral SM, Goodman KE, Blanco N . Comorbidity and severity-of-illness risk adjustment for hospital-onset Clostridioides difficile infection using data from the electronic medical record. Infect Control Hosp Epidemiol 2021 Aug;42(8):955-61. doi: 10.1017/ice.2020.1344..
View abstract on the National Library of Medicine site.
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Hospitals, Risk
Safdar N, Parmasad V, Brown R
Decreasing ICU-associated Clostridioides difficile infection through fluoroquinolone restriction, the FIRST trial: a study protocol.
Clostridioides difficile infection (CDI) is one of the most common healthcare-associated infections in the USA, having high incidence in intensive care units (ICU). Antibiotic use increases risk of CDI, with fluoroquinolones (FQs) particularly implicated. In healthcare settings, antibiotic stewardship (AS) and infection control interventions are effective in CDI control, but there is little evidence regarding the most effective AS interventions. In this paper the investigators describe their multisite, stepped-wedge, cluster, effectiveness-implementation clinical trial.
AHRQ-funded; R01 HS026226.
Citation: Safdar N, Parmasad V, Brown R . Decreasing ICU-associated Clostridioides difficile infection through fluoroquinolone restriction, the FIRST trial: a study protocol. BMJ Open 2021 Jun 29;11(6):e046480. doi: 10.1136/bmjopen-2020-046480..
View abstract on the National Library of Medicine site.
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Intensive Care Unit (ICU), Antimicrobial Stewardship, Antibiotics, Medication, Prevention
Golob JL, Rao K
Signal versus noise: how to analyze the microbiome and make progress on antimicrobial resistance.
This paper’s objective is to: 1) review the current thought on risk from antibiotic-resistant organization (ARO) acquisition; 2) review the current understanding on the gut microbiome’s ability to resist colonization with AROs; 3) describe how experimental model systems can test these global initial, global insights to arrive at more granular, mechanistic ones; and 4) suggest a path forward to make further progress in the field. This review is informed from experiences and successes with understanding of the role of the microbiome in mediating risk of Clostridioides difficile infection.
AHRQ-funded; HS027431.
Citation: Golob JL, Rao K . Signal versus noise: how to analyze the microbiome and make progress on antimicrobial resistance. J Infect Dis 2021 Jun 16;223(Suppl 3):S214-S21. doi: 10.1093/infdis/jiab184..
View abstract on the National Library of Medicine site.
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Genetics
Tamma PD, Miller MA, Dullabh P
AHRQ Author: Miller MA
Association of a safety program for improving antibiotic use with antibiotic use and hospital-onset Clostridioides difficile infection rates among US hospitals.
Regulatory agencies and professional organizations recommend antibiotic stewardship programs (ASPs) in US hospitals. The optimal approach to establish robust, sustainable ASPs across diverse hospitals is unknown. The purpose of this study was to assess whether the Agency for Healthcare Research and Quality (AHRQ) Safety Program for Improving Antibiotic Use was associated with reductions in antibiotic use across US hospitals. The investigators concluded that AHRQ Safety Program appeared to enable diverse hospitals to establish ASPs and teach frontline clinicians to self-steward their antibiotic use.
AHRQ-authored; AHRQ-funded; 233201500020I.
Citation: Tamma PD, Miller MA, Dullabh P . Association of a safety program for improving antibiotic use with antibiotic use and hospital-onset Clostridioides difficile infection rates among US hospitals. JAMA Netw Open 2021 Feb;4(2):e210235. doi: 10.1001/jamanetworkopen.2021.0235..
View abstract on the National Library of Medicine site.
Keywords: Antimicrobial Stewardship, Antibiotics, Medication, Decision Making, Clostridium difficile Infections, Patient Safety, Quality Improvement, Quality of Care, Hospitals
Schoyer 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..
View abstract on the National Library of Medicine site.
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..
View abstract on the National Library of Medicine site.
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..
View abstract on the National Library of Medicine site.
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..
View abstract on the National Library of Medicine site.
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..
View abstract on the National Library of Medicine site.
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..
View abstract on the National Library of Medicine site.
Keywords: Clostridium difficile Infections, Infectious Diseases, Healthcare-Associated Infections (HAIs), Antibiotics, Medication, Treatments
Flores EJ, Jue JJ, Giradi G
AHRQ EPC series on Improving translation of evidence: use of a clinical pathway for C. difficile treatment to facilitate the translation of research findings into practice.
In this pilot study, findings from the 2016 AHRQ EPC report on Clostridioides difficile infection were translated into a treatment pathway and disseminated via a cloud-based platform and electronic health record (EHR). Results indicated that pathways can be an approach for disseminating AHRQ EPC report findings within health care systems, with reports including guideline and pathway syntheses. Embedding hyperlinks to pathway content within the EHR may be a viable and low-effort solution for promoting awareness of evidence-based resources.
AHRQ-funded.
Citation: Flores EJ, Jue JJ, Giradi G . AHRQ EPC series on Improving translation of evidence: use of a clinical pathway for C. difficile treatment to facilitate the translation of research findings into practice. Jt Comm J Qual Patient Saf 2019 Dec;45(12):822-28. doi: 10.1016/j.jcjq.2019.10.002..
View abstract on the National Library of Medicine site.
Keywords: Implementation, Evidence-Based Practice, Infectious Diseases, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Electronic Health Records (EHRs), Health Information Technology (HIT)
Turner NA, Grambow SC, Woods CW
Epidemiologic trends in Clostridioides difficile infections in a regional community hospital network.
Clostridioides difficile infection (CDI) remains a leading cause of health care facility-associated infection. A greater understanding of the regional epidemiologic profile of CDI could inform targeted prevention strategies. The objectives of this study was to assess trends in incidence of health care facility-associated and community-acquired CDI among hospitalized patients over time and to conduct a subanalysis of trends in the NAP1 strain of CDI over time.
AHRQ-funded; HS023866.
Citation: Turner NA, Grambow SC, Woods CW . Epidemiologic trends in Clostridioides difficile infections in a regional community hospital network. JAMA Netw Open 2019 Oct 2;2(10):e1914149. doi: 10.1001/jamanetworkopen.2019.14149..
View abstract on the National Library of Medicine site.
Keywords: Clostridium difficile Infections, Community-Acquired Infections, Infectious Diseases, Hospitals
Musuuza JS, Hundt AS, Carayon P
Implementation of a Clostridioides difficile prevention bundle: understanding common, unique, and conflicting work system barriers and facilitators for subprocess design.
This study assessed the factors that should be considered when designing subprocesses of a Clostridioides difficile (C. difficile) prevention bundle. Three focus groups were conducted with environmental services staff, physicians and nurses to assess their perspectives on the prevention bundle and barriers to implementation. Common barriers included inconsistencies in knowledge and practice of CD management procedures; increased workload; poor setup of aspects of the physical environment; and inconsistencies in CD documentation. There were also unique barriers in different hospital environments. The authors recommend a systems engineering approach to help holistically identify factors that influence successful implementation of subprocesses of the CD infection prevention bundle.
AHRQ-funded; HS023791.
Citation: Musuuza JS, Hundt AS, Carayon P . Implementation of a Clostridioides difficile prevention bundle: understanding common, unique, and conflicting work system barriers and facilitators for subprocess design. Infect Control Hosp Epidemiol 2019 Aug;40(8):880-88. doi: 10.1017/ice.2019.150..
View abstract on the National Library of Medicine site.
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Patient Safety, Prevention
Misch EA, Safdar N
Clostridioides difficile infection in the stem cell transplant and hematologic malignancy population.
This article describes a study underway with patients who have undergone a stem cell transplant due to a hematologic malignancy who subsequently contracted a Clostridioides difficile (CD) infection. A new treatment for CD infection is the use of a fecal microbiota transplant (FMT), but it has not been widely adopted in transplant patients because of safety concerns. A randomized controlled trial of FMT in transplant patients is now underway.
AHRQ-funded; HS026226; HS025713.
Citation: Misch EA, Safdar N . Clostridioides difficile infection in the stem cell transplant and hematologic malignancy population. Infect Dis Clin North Am 2019 Jun;33(2):447-66. doi: 10.1016/j.idc.2019.02.010..
View abstract on the National Library of Medicine site.
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Cancer
Hessels AJ, Kelly AM, Chen L
Impact of infectious exposures and outbreaks on nurse and infection preventionist workload.
Researchers evaluated workload increases reported by staff nurses and infection preventionists (IPs) in response to common exposures and outbreaks. Using surveys, they concluded that organisms that are easier to treat and more difficult to spread, such as scabies or lice, can contribute substantially to nursing workload. Additionally, three-quarters of the nurses and one-half of the IPs reported that C difficile adds more than one hour to their daily workload.
AHRQ-funded; HS024915.
Citation: Hessels AJ, Kelly AM, Chen L . Impact of infectious exposures and outbreaks on nurse and infection preventionist workload. Am J Infect Control 2019 Jun;47(6):623-27. doi: 10.1016/j.ajic.2019.02.007..
View abstract on the National Library of Medicine site.
Keywords: Burnout, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Infectious Diseases, Provider: Nurse, Public Health
Caroff DA, Menchaca JT, Zhang Z
Oral vancomycin prophylaxis during systemic antibiotic exposure to prevent Clostridiodes difficile infection relapses.
This study’s goal was to determine if giving hospitalized patients oral vancomycin along with systematic antibiotics prevents relapse of Cloistridioides difficile infection (CDI). The results show that the outcome was not statistically significant, although it may help patients who have only had 1 prior CDI episode.
AHRQ-funded; HS025008.
Citation: Caroff DA, Menchaca JT, Zhang Z . Oral vancomycin prophylaxis during systemic antibiotic exposure to prevent Clostridiodes difficile infection relapses. Infect Control Hosp Epidemiol 2019 Jun;40(6):662-67. doi: 10.1017/ice.2019.88..
View abstract on the National Library of Medicine site.
Keywords: Antibiotics, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Medication, Prevention
Olsen MA, Stwalley D, Demont C
Clostridium difficile infection increases acute and chronic morbidity and mortality.
The goal of this study was to quantify short- and long-term outcomes of Clostridium difficile infection in the elderly, using 2011 Medicare claims data. The claims records of 174,903 patients coded for Clostridium difficile infection were compared with those of 1,318,538 control patients. The authors concluded that Clostridium difficile infection was associated with increased risk of short- and long-term adverse outcomes, including transfer to short- and long-term care facilities, hospitalization, and all-cause mortality.
AHRQ-funded; HS019455.
Citation: Olsen MA, Stwalley D, Demont C . Clostridium difficile infection increases acute and chronic morbidity and mortality. Infect Control Hosp Epidemiol 2019 Jan;40(1):65-71. doi: 10.1017/ice.2018.280..
View abstract on the National Library of Medicine site.
Keywords: Clostridium difficile Infections, Elderly, Medicare, Outcomes
D'Agata EMC, Tran D, Bautista J
Clinical and economic benefits of antimicrobial stewardship programs in hemodialysis facilities: a decision analytic model.
In this study, the authors developed a decision analytic model of antimicrobial use on the clinical and economic consequences of implementing a nationwide antimicrobial stewardship program in outpatient dialysis facilities. The authors found that the model suggested that implementation of antimicrobial stewardship programs in outpatient dialysis facilities would result in substantial reductions in infections caused by multidrug-resistant organisms and C. difficile, infection-related deaths, and costs.
AHRQ-funded; R18 HS021666.
Citation: D'Agata EMC, Tran D, Bautista J . Clinical and economic benefits of antimicrobial stewardship programs in hemodialysis facilities: a decision analytic model. Clin J Am Soc Nephrol 2018 Sep 7;13(9):1389-97. doi: 10.2215/cjn.12521117..
View abstract on the National Library of Medicine site.
Keywords: Antimicrobial Stewardship, Dialysis, Decision Making, Antibiotics, Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Medication, Healthcare Costs, Patient Safety
Anderson DJ, Moehring RW, Weber DJ
Effectiveness of targeted enhanced terminal room disinfection on hospital-wide acquisition and infection with multidrug-resistant organisms and Clostridium difficile: a secondary analysis of a multicentre cluster randomised controlled trial with crossover
In this study, the investigators aimed to assess the effectiveness of four disinfection strategies on hospital-wide incidence of multidrug-resistant organisms and Clostridium difficile in the Benefits of Enhanced Terminal Room (BETR) Disinfection study. The investigators found that enhanced terminal room disinfection with ultraviolet (UV) in a targeted subset of high-risk rooms led to a decrease in hospital-wide incidence of C difficile and vancomycin-resistant enterococci.
AHRQ-funded; HS023866.
Citation: Anderson DJ, Moehring RW, Weber DJ . Effectiveness of targeted enhanced terminal room disinfection on hospital-wide acquisition and infection with multidrug-resistant organisms and Clostridium difficile: a secondary analysis of a multicentre cluster randomised controlled trial with crossover Lancet Infect Dis 2018 Aug;18(8):845-53. doi: 10.1016/s1473-3099(18)30278-0..
View abstract on the National Library of Medicine site.
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Hospitals, Infectious Diseases, Inpatient Care, Patient Safety, Prevention
Harris AD, Sbarra AN, Leekha S
Electronically available comorbid conditions for risk prediction of healthcare-associated Clostridium difficile infection.
This study analyzed whether electronically available comorbid conditions are risk factors for Centers for Disease Control and Prevention (CDC)-defined, hospital-onset Clostridium difficile infection (CDI) after controlling for antibiotic and gastric acid suppression therapy use. It concluded that comorbid conditions are important risk factors for CDI.
AHRQ-funded; HS022291.
Citation: Harris AD, Sbarra AN, Leekha S . Electronically available comorbid conditions for risk prediction of healthcare-associated Clostridium difficile infection. Infect Control Hosp Epidemiol 2018 Mar;39(3):297-301. doi: 10.1017/ice.2018.10.
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View abstract on the National Library of Medicine site.
Keywords: Clostridium difficile Infections, Electronic Health Records (EHRs), Healthcare-Associated Infections (HAIs), Patient Safety, Risk
Psoinos CM, Collins CE, Ayturk MD
Post-hospitalization treatment regimen and readmission for C. difficile colitis in Medicare beneficiaries.
C. difficile (CDI) has surpassed methicillin-resistant staph aureus as the most common nosocomial infection with recurrence reaching 30% and the elderly being disproportionately affected. The authors hypothesized that post-discharge antibiotic therapy for continued CDI treatment reduces readmissions. The study concluded that patients discharged with single-drug therapy for CDI had lower readmission rates compared to patients discharged on no ongoing CDI treatment suggesting that short-term monotherapy may be beneficial in inducing eradication and preventing relapse.
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AHRQ-funded; HS022694
Citation: Psoinos CM, Collins CE, Ayturk MD . Post-hospitalization treatment regimen and readmission for C. difficile colitis in Medicare beneficiaries. World J Surg 2018 Jan;42(1):246-53. doi: 10.1007/s00268-017-4139-8..
View abstract on the National Library of Medicine site.
Keywords: Antibiotics, Clostridium difficile Infections, Elderly, Hospital Discharge, Hospital Readmissions

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