Multicenter study of Clostridium difficile infection rates from 2000 to 2006.
Multicenter study of Clostridium difficile infection rates from 2000 to 2006.
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DOI：
10.1086/656245
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发表时间：
2010-10
影响因子：
4.5
通讯作者：
Fraser VJ
中科院分区：
文献类型：
--
作者：
Dubberke ER;Butler AM;Yokoe DS;Mayer J;Hota B;Mangino JE;Khan YM;Popovich KJ;Fraser VJ
为了比较艰难梭菌感染(CDI)在美国五个不同地理位置的学术医疗中心6年间的发病率，使用推荐的标准化CDI监测定义，其中纳入了最近的医疗机构(HCF)暴露。艰难梭菌毒素检测结果以及入院、出院和化验日期的数据来自电子医院数据库。对入院后48小时内发现艰难梭菌毒素检测阳性的患者进行图表审查，以确定入院前90天内的HCF暴露情况。CDI病例被定义为任何粪便毒素检测艰难梭菌阳性的住院患者，根据最近接触的HCF被分为五个监测定义。用趋势卡方检验和卡方汇总检验计算和评价年度CDI率。在研究期间，以下方面的总体发病率有显著增加：起病的医院感染(7.0%至8.5例/10,000病人日(p<；0.001))；社区起病的致残相关的医院感染(1.1%至1.3例/10,000病人日(p=0.003))；以及社区起病的致残相关的其他致病感染(0.8%至1.5例/1,000入院(p<；0.001))。对于每一种CDI监测定义，不同机构之间的总发病率存在显著差异。CDI的发病率随着时间的推移和跨机构的增加，以及不同类别CDI发病率的相关性表明，CDI可能是一个地区性问题，而不是孤立于单一的医疗机构。
To compare Clostridium difficile infection (CDI) incidence rates during a 6-year period among five geographically diverse academic medical centers across the United States using recommended standardized CDI surveillance definitions that incorporate recent healthcare facility (HCF) exposures. Data on C. difficile toxin assay results and dates of admission, discharge and assays were collected from electronic hospital databases. Chart review was performed for patients with a positive C. difficile toxin assay identified within 48 hrs of admission to determine HCF exposures in the 90 days prior to hospital admission. CDI cases, defined as any inpatient with a positive stool toxin assay for C. difficile, were categorized into five surveillance definitions based on recent HCF exposure. Annual CDI rates were calculated and evaluated with chi-square test for trend and chi-square summary tests. Over the study period, there were significant increases in the overall incidence rates of hospital-onset, HCF-associated CDI (7.0 to 8.5 cases/10,000 patient days (p < 0.001)); community-onset, HCF-associated – study hospital CDI (1.1 to 1.3 cases/10,000 patient-days (p = 0.003)); and community-onset, HCF-associated – other HCF CDI (0.8 to 1.5 cases/1,000 admissions overall (p < 0.001)). For each CDI surveillance definition, there were significant differences in total incidence rates between institutions. The increasing incidence rates of CDI over time and across institutions, and correlation of CDI incidence in different categories suggest that CDI may be a regional problem, and not isolated to single healthcare facilities.
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影响因子：
158.5
作者：
McDonald, LC;Killgore, GE;Gerding, DN
通讯作者：
Gerding, DN
影响因子：
11.8
作者：
McDonald, LC;Owings, M;Jernigan, DB
通讯作者：
Jernigan, DB
影响因子：
4.5
作者：
McDonald, L. Clifford;Coignard, Bruno;Kutty, Preeta K.
通讯作者：
Kutty, Preeta K.
影响因子：
11.8
作者：
Gravel, Denise;Miller, Mark;Mulvey, Michael
通讯作者：
Mulvey, Michael
影响因子：
158.5
作者：
Loo, VG;Poirier, L;Dascal, A
通讯作者：
Dascal, A