ArticlePloS one2020
Reduced Clostridioides difficile infection in a pragmatic stepped-wedge initiative using admission surveillance to detect colonization.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04014608 (Admission Toxigenic C. Difficile Surveillance to Reduce Hospital Onset C. Difficile Infection), which is not on this map. Cited by 4 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Admission Toxigenic C. Difficile Surveillance to Reduce Hospital Onset C. Difficile Infection (CDI)
Who cites it
4 citing papers in PubMed, 8 citations in OpenAlex.
- Screening for Asymptomatic Clostridioides difficile Carriage Among Hospitalized Patients: A Narrative Review.Infectious diseases and therapy · 2023Review
- Strategies to preventInfection control and hospital epidemiology · 2023Article
- Article
- Post-infectious irritable bowel syndrome after a laboratory-proven enteritis.Experimental and therapeutic medicine · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundClostridioides difficile Infection (CDI) is a persistent healthcare issue. In the US, CDI is the most common infectious cause of hospital-onset (HO) diarrhea.
objectiveAssess the impact of admission testing for toxigenic C. difficile colonization on the incidence of HO-CDI.
designPragmatic stepped-wedge Infection Control initiative.
settingNorthShore University HealthSystem is a four-hospital system near Chicago, IL. PATIENTS: All patients admitted to the four hospitals during the initiative.
interventionsFrom September 2017 through August 2018 we conducted a quality improvement program where admitted patients had a peri-rectal swab tested for toxigenic C. difficile. All colonized patients were placed into contact precautions. MEASUREMENTS: We tested admissions who: i) had been hospitalized within two months, ii) had a past C. difficile positive test, and/or iii) were in a long-term care facility within six months. We measured compliance with all other practices to reduce the incidence of HO-CDI.
results30% of admissions were tested and 8.3% were positive. In the year prior to the initiative (Period 1) there were 63,057 admitted patients when HO-CDI incidence was 5.96 cases/10,000 patient days. During the 12-month initiative (Period 2) there were 62,760 admissions and the HO-CDI incidence was 4.23 cases/10,000 patient days (p = 0.02). There were no other practice or antibiotic use changes. Continuing admission surveillance provided a HO-CDI incidence of 2.9 cases/10,000 patient days during the final 9 months of 2018 (p<0.0001 compared to Period 1), equaling <1 case/1,000 admissions. LIMITATIONS: This was not a randomized controlled trial, and multiple prevention practices were in place at the time of the admission surveillance initiative.
conclusionAdmission C. difficile surveillance testing is an important tool for preventing hospital-onset C. difficile infection. REGISTRATION: This quality improvement initiative is registered at ClinicalTrials.gov. The unique registration identifier number is NCT04014608.
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