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Patients With CKD Have Higher Rates of CDI

Patients with chronic kidney disease (CKD) appear to have a higher risk of Clostridium difficile infection (CDI) and hospital-associated morbidity and mortality when compared with patients who do not have CKD. A team of American researchers found that patients with CKD had a CDI rate of 1.49%, compared with a 0.70% rate for those without CKD. Abstract: Mayo Clinic Proceedings, November...

CDI: Making the Case for Better Prevention Efforts

Clostridium difficile infection (CDI) is a common and sometimes fatal healthcare–associated infection. It manifests as diarrhea that often recurs and can progress to toxic megacolon, sepsis, and death. “The incidence, mor­tality, and healthcare costs resulting from CDIs in hospitalized patients have reached historic highs,” says L. Clifford McDonald, MD, FACP, FSHEA. “CDI often occurs in patients in healthcare settings where antibiotics are prescribed and symp­tomatic patients are concentrated.” From 2000 to 2009, the number of hospitalized patients with any CDI discharge diagnoses more than doubled; the number with a primary CDI diagnosis more than tripled. “While the incidence of other healthcare-associated infections has declined, the incidence of CDI has increased,” Dr. McDonald says. Evidence-based guidelines are available for preventing CDI in hospitals, but the degree to which adherence to these guidelines can effectively help prevent these infections is unknown. Analyzing the Impact of CDI In the March 13, 2012 Morbidity & Mortality Weekly Report, Dr. McDonald and colleagues published a study that sought to identify healthcare exposures for CDI, determine the pro­portion of CDI occurring outside hospital settings, and assess whether prevention programs can effectively reduce CDI. The research team analyzed population-based data from the Emerging Infections Program as well as present-on-admission and hospital-onset, laboratory-identified CDI events that were reported to the National Healthcare Safety Network (NHSN). When analyzing data from the Emerging Infec­tions Program, 10,342 CDIs were identified. “Overall, 94% of all CDIs were related to various precedent and concurrent healthcare exposures,” says Dr. McDonald. “About three-fourths of CDIs had their onset occur outside of hospitals [Figure 1]. It should also be noted that some cases occurred in...

Conference Highlights: ICAAC Annual Meeting

The 50th Interscience Conference on Antimicrobial Agents and Chemotherapy, or ICAAC, held its 2010 annual meeting from September 12 to 15 in Boston. Among the news emerging from the meeting was the risk of invasive aspergillosis in non-traditional patients, the continuing danger of sharps injuries, and a new potential treatment for recurrent CDI. Soap & Water Wipes Reduce Wrestlers’ Skin Infections A Potential New Treatment for Recurrent CDI Looking at the Effect of Public Data on Performance Patients Shed H1N1 Virus Longer Risk of Invasive Aspergillosis in Non-Traditional Patients Sharps Injuries Still a Danger Water Wipes Reduce Wrestlers’ Skin Infections The Particulars: Skin infections are common among high school wrestlers. The vast majority arise within 1 week following exposure, including tinea corporus, folliculitis/impetigo, and herpetic infections. Weekend tournaments that extend over a 10- to 12-hour period allow for long periods of potential exposure to pathogens that may cause these infections to propagate. Data Breakdown: A study of 151 high school wrestlers found that those who used soap and water wipes following a match reduced their risk of skin infection by 97% when compared with athletes who used a 75% alcohol wipe or no wipe at all. Those who used soap and water wipes had only one instance of bacterial infection, with an odds ratio (OR) of 0.089. Those in the alcohol wipe group had three bacterial infections and one herpes infection (OR, 0.44). Wrestlers who did not wipe off after a match had four instances of tinea corporis, two bacterial infections, and two outbreaks of herpes. Take Home Pearl: High school wrestlers may be able to significantly reduce their...
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