Impact of an Intervention Program on Clostridioides difficile Infections: Comparison of 2 Hospital Cohorts.

BACKGROUND: Clostridioides difficile infection (CDI) occurs in various contexts and care settings and is managed by multiple specialists who are not experts in its management. While there are many initiatives to improve the diagnosis and avoid overdiagnosis, there is less focus on the overall manage...

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Autores: Kamel, S, Corbacho-Loarte, MD, Escudero-Sánchez, R, Halperin, A, Llorente, S, Quevedo, SM, Suárez-Carantona, C, del Campo, L, Hernández, MS, Guillen, SM, Cobo, J
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2024
País:España
Institución:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
Repositorio:r-FISABIO. Repositorio Institucional de Producción Científica
OAI Identifier:oai:fisabio.fundanetsuite.com:p17941
Acceso en línea:https://fisabio.portalinvestigacion.com/publicaciones/17941
Access Level:acceso abierto
Palabra clave:CDI readmissions
CDI recurrence
Clostridioides difficile infection
IDS value
continuity of care
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spelling Impact of an Intervention Program on Clostridioides difficile Infections: Comparison of 2 Hospital Cohorts.Kamel, SCorbacho-Loarte, MDEscudero-Sánchez, RHalperin, ALlorente, SQuevedo, SMSuárez-Carantona, Cdel Campo, LHernández, MSGuillen, SMCobo, JCDI readmissionsCDI recurrenceClostridioides difficile infectionIDS valuecontinuity of careBACKGROUND: Clostridioides difficile infection (CDI) occurs in various contexts and care settings and is managed by multiple specialists who are not experts in its management. While there are many initiatives to improve the diagnosis and avoid overdiagnosis, there is less focus on the overall management of the infection. METHODS: We studied a cohort of patients with a positive test result for toxigenic C difficile in 2 hospitals. Hospital A has a program that provides advice from an infectious disease specialist (IDS) and promotes continuity of care by providing a phone number to contact the IDS. Hospital B does not have any specific CDI program. The evaluation assessed the proportion of patients not treated (carriers or self-limited disease), adherence to Infectious Diseases Society of America guidelines, access to novel therapies, recurrence and mortality rates, and readmission and emergency department visits due to CDI. We assessed the program's effectiveness through a logistic regression model adjusted for covariates chosen by clinical criteria. RESULTS: Hospital A avoided more unnecessary treatments (19.3% vs 11.5%), provided access to novel therapies more frequently (35.3% vs 13%), and adhered more closely to current guidelines (95.8% vs 71.3%). Although the mortality and recurrence rates did not differ, the absence of an intervention program was associated with greater odds of admission due to recurrence (odds ratio, 4.19; P = .037) and more visits to the emergency department due to CDI (odds ratio, 8.74; P = .001). CONCLUSIONS: Implementation of a CDI intervention program based on recommendations from IDSs and improved access to specialized care during the follow-up is associated with enhanced quality of CDI management and potential reductions in hospital resource utilization.OXFORD UNIV PRESS INC2024info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://fisabio.portalinvestigacion.com/publicaciones/17941Open Forum Infectious DiseasesISSN: 23288957reponame:r-FISABIO. Repositorio Institucional de Producción Científicainstname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)Inglésinfo:eu-repo/semantics/openAccessoai:fisabio.fundanetsuite.com:p179412026-06-11T12:45:17Z
dc.title.none.fl_str_mv Impact of an Intervention Program on Clostridioides difficile Infections: Comparison of 2 Hospital Cohorts.
title Impact of an Intervention Program on Clostridioides difficile Infections: Comparison of 2 Hospital Cohorts.
spellingShingle Impact of an Intervention Program on Clostridioides difficile Infections: Comparison of 2 Hospital Cohorts.
Kamel, S
CDI readmissions
CDI recurrence
Clostridioides difficile infection
IDS value
continuity of care
title_short Impact of an Intervention Program on Clostridioides difficile Infections: Comparison of 2 Hospital Cohorts.
title_full Impact of an Intervention Program on Clostridioides difficile Infections: Comparison of 2 Hospital Cohorts.
title_fullStr Impact of an Intervention Program on Clostridioides difficile Infections: Comparison of 2 Hospital Cohorts.
title_full_unstemmed Impact of an Intervention Program on Clostridioides difficile Infections: Comparison of 2 Hospital Cohorts.
title_sort Impact of an Intervention Program on Clostridioides difficile Infections: Comparison of 2 Hospital Cohorts.
dc.creator.none.fl_str_mv Kamel, S
Corbacho-Loarte, MD
Escudero-Sánchez, R
Halperin, A
Llorente, S
Quevedo, SM
Suárez-Carantona, C
del Campo, L
Hernández, MS
Guillen, SM
Cobo, J
author Kamel, S
author_facet Kamel, S
Corbacho-Loarte, MD
Escudero-Sánchez, R
Halperin, A
Llorente, S
Quevedo, SM
Suárez-Carantona, C
del Campo, L
Hernández, MS
Guillen, SM
Cobo, J
author_role author
author2 Corbacho-Loarte, MD
Escudero-Sánchez, R
Halperin, A
Llorente, S
Quevedo, SM
Suárez-Carantona, C
del Campo, L
Hernández, MS
Guillen, SM
Cobo, J
author2_role author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv CDI readmissions
CDI recurrence
Clostridioides difficile infection
IDS value
continuity of care
topic CDI readmissions
CDI recurrence
Clostridioides difficile infection
IDS value
continuity of care
description BACKGROUND: Clostridioides difficile infection (CDI) occurs in various contexts and care settings and is managed by multiple specialists who are not experts in its management. While there are many initiatives to improve the diagnosis and avoid overdiagnosis, there is less focus on the overall management of the infection. METHODS: We studied a cohort of patients with a positive test result for toxigenic C difficile in 2 hospitals. Hospital A has a program that provides advice from an infectious disease specialist (IDS) and promotes continuity of care by providing a phone number to contact the IDS. Hospital B does not have any specific CDI program. The evaluation assessed the proportion of patients not treated (carriers or self-limited disease), adherence to Infectious Diseases Society of America guidelines, access to novel therapies, recurrence and mortality rates, and readmission and emergency department visits due to CDI. We assessed the program's effectiveness through a logistic regression model adjusted for covariates chosen by clinical criteria. RESULTS: Hospital A avoided more unnecessary treatments (19.3% vs 11.5%), provided access to novel therapies more frequently (35.3% vs 13%), and adhered more closely to current guidelines (95.8% vs 71.3%). Although the mortality and recurrence rates did not differ, the absence of an intervention program was associated with greater odds of admission due to recurrence (odds ratio, 4.19; P = .037) and more visits to the emergency department due to CDI (odds ratio, 8.74; P = .001). CONCLUSIONS: Implementation of a CDI intervention program based on recommendations from IDSs and improved access to specialized care during the follow-up is associated with enhanced quality of CDI management and potential reductions in hospital resource utilization.
publishDate 2024
dc.date.none.fl_str_mv 2024
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://fisabio.portalinvestigacion.com/publicaciones/17941
url https://fisabio.portalinvestigacion.com/publicaciones/17941
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv OXFORD UNIV PRESS INC
publisher.none.fl_str_mv OXFORD UNIV PRESS INC
dc.source.none.fl_str_mv Open Forum Infectious Diseases
ISSN: 23288957
reponame:r-FISABIO. Repositorio Institucional de Producción Científica
instname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
instname_str Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
reponame_str r-FISABIO. Repositorio Institucional de Producción Científica
collection r-FISABIO. Repositorio Institucional de Producción Científica
repository.name.fl_str_mv
repository.mail.fl_str_mv
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