Pathway to Prevention of Nosocomial Clostridium difficile Infection Journal Article


Authors: Goldstein, E. J.; Johnson, S; Maziade, P. J.; McFarland, L. V.; Trick, W.; Dresser, L.; Millette, M.; Mazloum, H.; Low, D. E.
Article Title: Pathway to Prevention of Nosocomial Clostridium difficile Infection
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.
Journal Title: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
Volume: 60 Suppl 2
ISSN: 1537-6591; 1058-4838
Publisher: . Published by Oxford University Press on behalf of the Infectious Diseases Society of America  
Journal Place: United States
Date Published: 2015
Start Page: S148
End Page: 58
Language: eng
DOI/URL:
Notes: CI: (c) The Author 2015; JID: 9203213; OTO: NOTNLM; ppublish
LUC Authors
  1. Stuart Brian Johnson
    41 Johnson
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