ArticlePloS one2016
Isolation of C. difficile Carriers Alone and as Part of a Bundle Approach for the Prevention of Clostridium difficile Infection (CDI): A Mathematical Model Based on Clinical Study Data.
Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 34 citations in OpenAlex.
- Clinical Practice Guidelines for Clostridium difficile Infection in Adults and Children: 2017 Update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA).Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2018Guideline
- Screening for Asymptomatic Clostridioides difficile Carriage Among Hospitalized Patients: A Narrative Review.Infectious diseases and therapy · 2023Review
- A review of epidemiological models of Clostridioides difficile transmission and control (2009-2021).Anaerobe · 2022Review
- Evaluation of the Cost-effectiveness of Infection Control Strategies to Reduce Hospital-Onset Clostridioides difficile Infection.JAMA network open · 2020Article
- Hospital Infection Control:Clinics in colon and rectal surgery · 2020Review
- Novel and emerging sources of Clostridioides difficile infection.PLoS pathogens · 2019Review
- A national survey of testing and management of asymptomatic carriage of C. difficile.Infection control and hospital epidemiology · 2019Article
- Consequences of delays and imperfect implementation of isolation in epidemic control.Scientific reports · 2019Article
- Association of Community Factors with Hospital-onsetEClinicalMedicine · 2019Article
- Understanding Clostridium difficile Colonization.Clinical microbiology reviews · 2018Review
- Assessing the effect of patient screening and isolation on curtailing Clostridium difficile infection in hospital settings.BMC infectious diseases · 2017Article
- Epidemiology ofThe open microbiology journal · 2017Article
- A Comparison of Current Guidelines of Five International Societies on Clostridium difficile Infection Management.Infectious diseases and therapy · 2016Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Clostridium difficile infection is the most common hospital-acquired infection. Besides infected patients, carriers have emerged as a key player in C. difficile epidemiology. In this study, we evaluated the impact of identifying and isolating carriers upon hospital admission on the incidence of CDI incidence and hospital-acquired C. difficile colonization, as a single policy and as part of bundle approaches. We simulated C. difficile transmission using a stochastic mathematical approach, considering the contribution of carriers based on published literature. In the baseline scenario, CDI incidence was 6.18/1,000 admissions (95% CI, 5.72-6.65), simulating reported estimates from U.S. hospital discharges. The acquisition rate of C. difficile carriage was 9.72/1,000 admissions (95% CI, 9.15-10.31). Screening and isolation of colonized patients on admission to the hospital decreased CDI incidence to 4.99/1,000 admissions (95% CI, 4.59-5.42; relative reduction (RR) = 19.1%) and led to 36.2% reduction in the rate of hospital-acquired colonization. Simulating an antimicrobial stewardship program reduced CDI rate to 2.35/1,000 admissions (95% CI, 2.07-2.65). In sensitivity analysis, CDI incidence was less than 2.32/1,000 admissions (RR = 62.4%) in 95% of 1,000 simulations. The combined bundle, focusing on reducing C. difficile transmission from colonized patients and the individual risk of these patients to develop CDI, decreased significantly the incidence of both CDI and hospital-acquired colonization. Implementation of this bundle to current practice is expected to have an important impact in containing CDI.
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