Secular trends in the epidemiology of Clostridium difficile infection (CDI): relationship with alcohol gel and antimicrobial usage in a hospital.
| Autor: | Silva M Jr; Intensive Care Unit, Hospital Israelita Albert Einstein, Av. Albert Einstein, 627/701, 5° Andar - Bloco B, São Paulo, CEP 05651-901, Brazil. moacyrjunior8@hotmail.com, Marra AR, Camargo TZ, Almeida SM, Siqueira I, Correa L, Kawagoe JY, dos Santos OF, Edmond MB |
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| Jazyk: | angličtina |
| Zdroj: | International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases [Int J Infect Dis] 2013 Jun; Vol. 17 (6), pp. e418-21. Date of Electronic Publication: 2013 Feb 15. |
| DOI: | 10.1016/j.ijid.2012.12.022 |
| Abstrakt: | Background: Clostridium difficile-associated diarrhea (CDAD) has shown increasing incidence, morbidity, and mortality in recent years. We assessed the number of CDAD tests requested, CDAD positivity rates, the use of alcohol-based hand rubs, and antimicrobial utilization. Methods: We collected information on every adult patient (>18 years) who developed diarrhea and had a positive stool test for C. difficile toxin from June 2005 to December 2009 at a tertiary care hospital. A time-series analysis was performed using monthly data on the incidence of C. difficile infection (CDI) (i.e., cases of infection per 1000 patient-days), as well as the consumption of alcohol-based hand rubs (in liters/1000-patient days) and antibiotics (in defined daily doses per 1000 patient-days). Results: The mean number of annual requests for C. difficile tests was 1031, and the rates per 1000 patient-days for each year from 2005 to 2009 were 0.30, 0.46, 0.39, 0.31, and 0.40 overall in the hospital, and 0.18, 0.10, 0.53, 0.38, and 0.37 in the intensive care unit (ICU). The use of alcohol-based hand rubs per 1000 patient-days increased from 37.4 to 73.0, and from 41.5 to 129.4 in the hospital and in the ICU, respectively. Conclusions: The incidence of CDI in the hospital and ICU remained low, despite the increased use of alcohol-based hand rubs and antimicrobials. (Copyright © 2013 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.) |
| Databáze: | MEDLINE |
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