Ellie J C Goldstein1, Stuart Johnson2, Pierre-Jean Maziade3, Lynne V McFarland4, William Trick5, Linda Dresser6, Mathieu Millette7, Hadi Mazloum7, Donald E Low8. 1. RM Alden Research Laboratory and the David Geffen School of Medicine at UCLA, Los Angeles, California. 2. Hines VA Hospital and Loyola University Medical Center, Chicago, Illinois. 3. Centre Hospitalier Pierre-Le Gardeur, Terrebonne, Quebec, Canada. 4. Department of Medicinal Chemistry, University of Washington, Seattle. 5. Collaborative Research Unit, Chicago, Illinois. 6. Leslie Dan Faculty of Pharmacy, University of Toronto, Ontario. 7. Bio-K Plus International Inc, Laval, Quebec. 8. Mount Sinai Hospital, University of Toronto, Ontario, Canada.
Abstract
BACKGROUND: To address the significant morbidity and mortality rates associated with nosocomial Clostridium difficile-associated diarrhea (CDAD), a series of recommendations and a pathway to prevention were developed. METHODS: An expert panel of infectious disease (ID) specialists participated in a modified Delphi process with specific objectives: (1) conduct a review for CDAD and prevention; (2) develop statements based upon panel members' opinions; (3) hold a panel meeting during the 2012 IDWeek; and (4) review the final recommendations and prevention pathway prior to submission for publication. RESULTS: The panel voted on (1) antibiotic stewardship (7 of 8 panelists); (2) reduction of other potentially modifiable risk factors (variable); (3) utilization of specific probiotics to prevent C. difficile overgrowth (8/8); (4) staff education regarding CDAD preventive measures (8/8); (5) appropriate hand hygiene for everyone (7/8); (6) environmental cleaning (8/8); (7) medical equipment disinfection (7/8); (8) early detection of CDAD in symptomatic patients (7/8); (9) usage of protective clothing/gloves (8/8); (10) proper measures during outbreak (8/8); and (11) surveillance to monitor efficacy data of preventive measures (8/8). CONCLUSIONS: The panel members agreed with 11 of 17 recommendations presented. The additional recommendations by the panel were proton pump inhibitor use as a risk factor and the use of adjunctive therapy with specific probiotic, as it was approved by Health Canada for the risk reduction of CDAD in hospitalized patients.
BACKGROUND: To address the significant morbidity and mortality rates associated with nosocomial Clostridium difficile-associated diarrhea (CDAD), a series of recommendations and a pathway to prevention were developed. METHODS: An expert panel of infectious disease (ID) specialists participated in a modified Delphi process with specific objectives: (1) conduct a review for CDAD and prevention; (2) develop statements based upon panel members' opinions; (3) hold a panel meeting during the 2012 IDWeek; and (4) review the final recommendations and prevention pathway prior to submission for publication. RESULTS: The panel voted on (1) antibiotic stewardship (7 of 8 panelists); (2) reduction of other potentially modifiable risk factors (variable); (3) utilization of specific probiotics to prevent C. difficile overgrowth (8/8); (4) staff education regarding CDAD preventive measures (8/8); (5) appropriate hand hygiene for everyone (7/8); (6) environmental cleaning (8/8); (7) medical equipment disinfection (7/8); (8) early detection of CDAD in symptomatic patients (7/8); (9) usage of protective clothing/gloves (8/8); (10) proper measures during outbreak (8/8); and (11) surveillance to monitor efficacy data of preventive measures (8/8). CONCLUSIONS: The panel members agreed with 11 of 17 recommendations presented. The additional recommendations by the panel were proton pump inhibitor use as a risk factor and the use of adjunctive therapy with specific probiotic, as it was approved by Health Canada for the risk reduction of CDAD in hospitalized patients.
Authors: Irene K Louh; William G Greendyke; Emilia A Hermann; Karina W Davidson; Louise Falzon; David K Vawdrey; Jonathan A Shaffer; David P Calfee; E Yoko Furuya; Henry H Ting Journal: Infect Control Hosp Epidemiol Date: 2017-04 Impact factor: 3.254
Authors: Jennifer K Spinler; Aaron Brown; Caná L Ross; Prapaporn Boonma; Margaret E Conner; Tor C Savidge Journal: Anaerobe Date: 2016-05-11 Impact factor: 3.331