| clostridium difficile infection in manchester. | | 1992 | 1285174 |
| clostridium difficile in london and staffordshire. | | 1992 | 1285182 |
| trés difficile. | | 1993 | 8454879 |
| antimicrobial associations of an outbreak of diarrhoea due to clostridium difficile. | an increased incidence of diarrhoea due to clostridium difficile (cdd) at the northern general hospital, sheffield, prompted an investigation into antibiotic use on the renal, medical and geriatric wards, those mostly affected. for the first half of 1997 affected patients on these wards were identified and data collected as to which antimicrobials they had taken between admission and diagnosis. rates were then calculated of the number of affected patients on a drug over the quantity prescribed ( ... | 1998 | 9699138 |
| clostridium difficile: an update on its epidemiology and role in hospital outbreaks in england and wales. | data from the surveillance system of general outbreaks of infectious intestinal disease and from laboratory reports collated by the communicable disease surveillance centre (cdsc) and requests for outbreak investigation by the phls anaerobe reference unit were used to evaluate the current epidemiology of clostridium difficile infection in england and wales. between january 1992 and december 1996, cdsc received 10,220 laboratory reports of c difficile isolation from patient's faeces and 26,873 of ... | 1999 | 10204123 |
| prospective evaluation of environmental contamination by clostridium difficile in isolation side rooms. | we determined prospectively the frequency, persistence and molecular epidemiology of clostridium difficile environmental contamination after detergent-based cleaning in side rooms used to isolate patients with c. difficile diarrhoea. approximately one-quarter of all environmental sites in side rooms sampled over four-week periods were contaminated with c. difficile. the overall side room prevalence of environmental c. difficile declined from 35% initially, to 24% in week 2, 18% in week 3, and 16 ... | 2001 | 11716638 |
| managing hospital infections. | major infections in hospitals may cause, or contribute to, patient deaths and, at best, disrupt hospital routines. elaine leaver describes the management response to a major infection in the hospital environment. | 1992 | 10121488 |
| guidelines for optimal surveillance of clostridium difficile infection in hospitals. | the availability of surveillance data on c. difficile infection in hospitals in england and wales is being jeopardised by the trend not to culture the organism for diagnostic purposes. nhs trust laboratories that no longer have the ability to isolate c. difficile cannot investigate putative outbreaks or monitor antimicrobial susceptibilities. these laboratories may now need to rely on their local public health laboratory for such investigations. recent recommendations from the department of heal ... | 1998 | 9854878 |
| human enteric pathogens identified in a london teaching hospital and a rural public health laboratory: 1994. | two microbiology laboratories, one serving an inner city hospital and one a rural public health laboratory, collected data on the outcome of examining faecal specimens in 1994. overall, 6.7% of the investigations were positive, but the rates were lower for hospital inpatients, for recently described pathogens, and in the absence of relevant clinical details; rates were higher for patients with a history of foreign travel. no benefit was gained by examining more than two specimens from any patien ... | 1998 | 9782627 |
| incidence and impact of clostridium difficile infection in the uk, 1993-1996. | questionnaires were sent to 360 uk medical microbiologists to determine the incidence of clostridium difficile infection in the uk between 1993-1996, and to establish the current laboratory testing protocols. replies were received from 104 laboratories (29% response rate), 86, 7, 4 and 3% of which are in england, scotland, wales and northern ireland, respectively. the laboratories serve a total of approximately 90,000 hospital beds (median 750). c. difficile testing was performed by 83% of the l ... | 1998 | 9699137 |
| do patients with clostridium difficile need to be isolated? | | 1997 | 9211164 |
| epidemiology and cost of nosocomial gastroenteritis, avon, england, 2002-2003. | healthcare-associated outbreaks of gastroenteritis are an increasingly recognized problem, but detailed knowledge of the epidemiology of these events is lacking. we actively monitored three hospital systems in england for outbreaks of gastroenteritis in 2002 to 2003. a total of 2,154 patients (2.21 cases/1,000-hospital-days) and 1,360 healthcare staff (0.47 cases/1,000-hospital-days) were affected in 227 unit outbreaks (1.33 outbreaks/unit-year). norovirus, detected in 63% of outbreaks, was the ... | 2004 | 15504271 |
| molecular typing of clostridium difficile. | | 1996 | 8854453 |
| cleaning up clostridium difficile infection. | | 1996 | 8813978 |
| uk launches inquiry into clostridium difficile outbreak. | | 2005 | 16027424 |
| infectious intestinal disease in elderly people. | this paper analyses routinely available data on infectious intestinal diseases occurring in people aged 65 years and over in england and wales from 1990 to 1994. these data include annual reports of consultations with general practitioners in spotter practices collated by the royal college of general practitioners, notifications of food poisoning collated by the office of population censuses and surveys, hospital admissions extracted from hospital episode statistics data, reports of general outb ... | 1996 | 8755672 |
| the distribution of clostridium difficile in the environment of south wales. | a large study of the distribution of clostridium difficile in the environment of the cardiff area of south wales was performed with a methodology designed to maximise recovery. a total of 2580 samples was taken, with 184 (7.1%) yielding isolates. the highest yield for c. difficile was obtained from river waters, with 14 (87.5%) of 16 samples from four rivers positive, and from sea water samples with 7 (44%) of 15 positive from six beaches on the bristol channel. in addition, 7 (46.7%) of 15 samp ... | 1996 | 8683549 |
| identification of outbreak-associated and other strains of clostridium difficile by numerical analysis of sds-page protein patterns. | seventy-three cultures of clostridium difficile isolated both during, and in the period immediately following, an outbreak of infection in a group of three hospitals, were characterized by one-dimensional sodium dodecyl sulphate-polyacrylamide gel electrophoresis (sds-page) of whole-cell proteins. each protein pattern was characterized by the presence of one or two dense bands which were highly reproducible. the protein patterns were used as the basis for a numerical analysis which divided the s ... | 1994 | 8062865 |
| management and control of a large outbreak of diarrhoea due to clostridium difficile. | in the six-month period 1 november 1991 to 1 may 1992 175 patients developed diarrhoea due to clostridium difficile in three hospitals in manchester, uk. most patients (90%) were over 60 years old and had been admitted to acute geriatric or medical wards with other illnesses. infection is thought to have contributed to 17 deaths. twenty-two patients relapsed clinically after antibiotic treatment. the outbreak began in one ward and affected 15 patients and two nurses. during the following months ... | 1994 | 7916358 |
| clostridium difficile diarrhoea. | | 1995 | 7738343 |
| clostridium difficile in an oncology unit. | in one year 21 new cases of clostridium difficile infection occurred on a paediatric oncology unit. eleven cases were in a two month period. this infection should be regarded as a communicable disease. investigations to detect c difficile should be carried out in children with malignant disease who have diarrhoea. | 1988 | 3415338 |
| there are lessons to be learnt in the aftermath of a scandal. | | 2006 | 16986585 |
| investigation of clostridium difficile diarrhoea in a district general hospital: room for improvement? | a retrospective survey of case-notes was carried out on all patients investigated for possible clostridium difficile diarrhoea during a 1-month period at a district general hospital. seven of 29 patients probably had the disease, but no case of pseudomembranous colitis was documented. delay in reporting and discrepancies between culture and cytotoxin results contributed in several cases to mismanagement. in 14 of 16 cases negative by culture and cytotoxin, a plausible non-microbiological case fo ... | 1987 | 2891751 |
| an investigation into clostridium perfringens enterotoxin-associated diarrhoea. | an investigation was carried out to establish the incidence of diarrhoea associated with the presence of enterotoxigenic clostridium perfringens. the results indicate a high risk group, namely elderly hospitalized patients, who should be investigated for this organism in a similar way to clostridium difficile if symptoms occur. the significance of antibiotic association is suggested and cross-infection was shown to be a possibility. detection of the enterotoxin was accompanied in all cases by th ... | 1991 | 1680904 |
| surveillance of clostridium difficile infection. | | 1992 | 1285121 |
| deaths involving clostridium difficile: england and wales, 2001-2005. | | 2007 | 17373384 |
| evidence to support the existence of subgroups within the uk epidemic clostridium difficile strain (pcr ribotype 1). | we used three different dna fingerprinting techniques and clindamycin susceptibility testing to confirm that clostridium difficile pcr ribotype i isolates can be divided into two subclones. this observation may permit a better understanding of the epidemiology and pathogenicity of c. difficile infection. | 2003 | 12767851 |
| the effect of an enhanced infection-control policy on the incidence of clostridium difficile infection and methicillin-resistant staphyloccocus aureus colonization in acute elderly medical patients. | clostridium difficile (cd) infection and methicillin-resistant staphylococcus aureus (mrsa) colonization are increasingly common in elderly patients, are associated with cephalosporin or prolonged aminopenicillin courses and can be transmitted by direct contact. management is by side-room isolation. ward closure may be required to control outbreaks. | 1998 | 12675094 |
| general outbreaks of infectious intestinal disease (iid) in hospitals, england and wales, 1992-2000. | between 1992 and 2000, 26.6% (1,396/5,257) of all general outbreaks of infectious intestinal disease (iid) reported to the public health laboratory service (phls) communicable disease surveillance centre (cdsc) occurred in hospitals. over 29,000 patients and staff were affected and the mortality risk was higher than for outbreaks in other settings [relative risk 2.00 (95% ci: 1.52-2.63) p<0.001]. person-to-person spread was the predominant mode of transmission. the mortality risk was highest in ... | 2003 | 12495678 |
| risk factors for the development of clostridium difficile toxin-associated diarrhoea: a pilot study. | this study was a pilot investigation of risk factors for the development of clostridium difficile toxin-associated diarrhoea and in particular the differential influence of antimicrobial agents. the study was a retrospective case-control design conducted at freeman hospital, newcastle upon tyne. cases were inpatients with stool positive c. difficile toxin diarrhoea and two controls were drawn for each case matched for age (+/- 5 years) and type of admission (emergency or elective). using conditi ... | 2001 | 11760491 |
| distribution of clostridium difficile pcr ribotype 027 in british hospitals. | | 2007 | 17868609 |
| contrasting incidence of clostridium difficile and other enteropathogens in aids patients in london and lusaka. | | 2000 | 10897357 |
| the rise of clostridium difficile: the effect of length of stay, patient age and antibiotic use. | hospitals in the uk have recently seen a marked increase in c. difficile for reasons which are unclear. reduced standards of hygiene, increasingly elderly patients, greater cephalosporin use and longer hospital stay have been suggested. we retrospectively studied all cases of c. difficile diarrhoea at princess margaret hospital, swindon, over two years. cephalosporins, patient age and los appeared unrelated to the rise in c. difficile; penicillins and macrolides were related. our policy of using ... | 2000 | 10896804 |
| an audit of the use of manual handling equipment and their microbiological flora--implications for infection control. | a review of the use of manual handling aids in two hospitals found equipment was employed on a multi-patient basis with inadequate cleaning. sampling with a casella slit sampler demonstrated frequent contamination by methicillin-resistant staphylococcus aureus and clostridium difficile of fabric aids. recommendations for care of equipment are made. | 1999 | 10658808 |
| detection of glycopeptide-resistant enterococci in routine diagnostic faeces specimens. | faeces received in a diagnostic laboratory were screened for glycopeptide-resistant enterococci (gre) on modified lewisham medium, with and without enrichment in enterococcosel broth. colonization by gre was detected in 102/838 patients (12.2%). in 74 (73%) of colonized patients gre were detected by both methods and in 28 (27%) they were detected only after enrichment. the carriage rate in hospitalized patients was 32% (93/289) compared with 2.3% (11/425) in the community (gp patients and food-h ... | 1999 | 10462636 |
| clostridium difficile in leicester hospital. | | 1999 | 10344091 |
| impact of changes in antibiotic policy on clostridium difficile-associated diarrhoea (cdad) over a five-year period in a district general hospital. | the impact of changes in antibiotic policy on clostridium difficile-associated diarrhoea (cdad), over a five-year period between 1995 and 2000, were studied in the preston acute hospitals trust. in 1996 the policy was changed in the preston acute hospitals trust from cefotaxime to ceftriaxone for initial treatment of severe sepsis or pneumonia in medical patients. over the next nine months the average number of patients with c. difficile toxin-positive stools per quarter increased from 16 to 39. ... | 2003 | 12818582 |
| service improvement. uprooting the causes. | root-cause analysis helps organisations to understand and address outcomes without focusing on the symptoms. a pilot led by eastern and coastal kent pct has helped the local health economy to plan to reduce infections. east kent hospitals is building a zero-tolerance culture. | 2007 | 18260604 |
| national clostridium difficile standards group: report to the department of health. | | 2004 | 15129935 |
| four country healthcare associated infection prevalence survey 2006: overview of the results. | a survey of adult patients was conducted in february 2006 to may 2006 in acute hospitals across england, wales, northern ireland and the republic of ireland to estimate the prevalence of healthcare-associated infections (hcais). a total of 75 694 patients were surveyed; 5743 of these had hcais, giving a prevalence of 7.59% (95% confidence interval: 7.40-7.78). hcai prevalence in england was 8.19%, in wales 6.35%, in northern ireland 5.43% and in the republic of ireland 4.89%. the most common hca ... | 2008 | 18550218 |
| the prevention of clostridium difficile associated diarrhoea in hospital. | the number of health care-associated infections has increased over the years and generated a lot of interest and concern. the attention tends to be focused on methicillin-resistant staphylococcus aureus (mrsa), but the less publicised clostridium difficile is a growing problem. it increases length of hospital stay, causes significant morbidity in patients, affects nurses' workloads, adds to the cost of cleaning, laundry and disposables, and can lead to ward closures. all nhs trusts in england ar ... | 2004 | 15318695 |
| impact of mandatory clostridium difficile surveillance on diagnostic services. | | 2004 | 15501344 |
| clostridium difficile: a questionnaire survey of laboratory practice in england, wales, and northern ireland. | since january 2004, the incidence of clostridium difficile associated disease (cdad) has been monitored by a systematic, national, laboratory surveillance system. this system incorporates the recommendations of a body of experts, the national clostridium difficile standards group, which was convened in 2002 to advise the department of health (doh). the recommendations of the group were informed by a questionnaire survey of current practice, and the results of that survey have been used to assess ... | 2004 | 15779799 |
| subtyping of clostridium difficile pcr ribotype 001 by rep-pcr and pfge. | the rep-pcr (repetitive sequence-based pcr using repetitive extragenic palindromic primers) typing method and a modified pfge method were applied to isolates of clostridium difficile pcr ribotype 001 with the aim of comparing their performance as methods of subtyping this organism. of 200 isolates from 60 hospitals tested by rep-pcr, eight subtypes were identified and labelled as rep-pcr subtypes 001-008. the predominant subtype, rep-pcr subtype 003, accounted for 47% of the total. fifty-two of ... | 2005 | 15888462 |
| a staff nurse's perspective of infection control problems. | earlier this month astonishing figures causing major concern were released from the department of health (doh) showing the number of cases of clostridium difficile in the over 65s in hospitals in england. this article focuses upon what is already known about infection control and concludes that a greater collaborative approach to infection control is needed, with a prudent use of broad spectrum antibiotics and a greater use of precautionary isolation measures based on patient symptoms, if infect ... | 2005 | 16224329 |
| beating the bugs. | | 2005 | 16259465 |
| prospective evaluation of hospital isolation room capacity. | risk assessment is used to determine the need for isolation in single rooms. limited availability of isolation rooms and/or operational needs may compromise this process. this article reports the results of a 12-month prospective observational study of every infection control request for isolation in a 1100-bed teaching hospital. in addition, four point-prevalence surveys of the usage of single rooms were carried out. data were collected on the incidence of new clinical meticillin-resistant stap ... | 2006 | 16697305 |
| deaths involving clostridium difficile: england and wales, 1999-2004. | | 2006 | 16759080 |
| outbreak of clostridium difficile infection in an english hospital linked to hypertoxin-producing strains in canada and the us. | | 2005 | 16783109 |
| number of c difficile cases rises. | | 2006 | 16873836 |
| major issues still to be addressed. | | 2006 | 17019902 |
| has the severity of clostridium difficile infections increased? | | 2007 | 17055114 |
| beating the bug. | | 2007 | 17539395 |
| hcais: statutory code of practice in england and wales. | healthcare-associated infections (hcais) such as meticillin resistant staphylococcus aureus (mrsa) and clostridium difficile (c. dif) are never far from the media headlines. in january 2006 a leaked memo identified the government's concerns that its target of halving mrsa infection rates by april 2008 may not be met (boseley 2007). during 2004-5, 30 people died following two outbreaks of c. dif at stoke mandeville (boseley 2007). in this article the author will focus on and discuss in detail key ... | 2007 | 17598676 |
| hse clears infection death managers. | | 2007 | 17847612 |
| annual incidence of mrsa falls in england, but c difficile continues to rise. | | 2007 | 17991958 |
| infection control. behind closed doors: is kent scandal a one-off. | | 2007 | 18020250 |
| lessons from the maidstone and tunbridge tragedy. | | 2007 | 18073641 |
| infection likely cause of 90 deaths. | | 2007 | 18161446 |
| progress at outbreak trust but doctor hygiene rapped. | | 2007 | 18161470 |
| use of highly discriminatory fingerprinting to analyze clusters of clostridium difficile infection cases due to epidemic ribotype 027 strains. | we compared multilocus variable-number tandem-repeat analysis (mlva) and macrorestriction endonuclease analysis using pulsed-field gel electrophoresis (pfge) to determine their utility to identify clusters of clostridium difficile infection (cdi) among 91 isolates of pcr ribotype 027 (nap1, for north american pulsed-field type 1) from nine hospitals (and 10 general practitioners associated with one institution) in england. we also examined whether mortality in cdi cases was associated with speci ... | 2008 | 18216211 |
| deaths involving clostridium difficle: england and wales, 1999 and 2001-06. | | 2008 | 18351026 |
| evaluating the link between the management of clinical waste in the national health service (nhs) and the risk of the spread of infections: a case study of three hospitals in england. | this study aimed to evaluate waste management practices in three case study nhs trusts in england and the potential risks of the spread of pathogens causing healthcare associated infections (hcais). using a combination of microbiological techniques, interviews and questionnaire surveys, four target microbes were studied, namely: meticillin resistant staphylococcus aureus (mrsa), meticillin sensitive staphylococcus aureus (mssa), clostridium difficile (c. difficile) and vancomycin-resistant enter ... | 2010 | 20833586 |
| deaths involving mrsa and clostridium difficile by communal establishment: england and wales, 2001-06. | | 2008 | 18595388 |
| deaths involving clostridium difficile; england and wales, 2003-07. | | 2008 | 18810888 |
| deaths from norovirus among the elderly, england and wales. | the number of deaths in england and wales associated with gastrointestinal pathogens, norovirus in particular, in persons >or=65 years was estimated for 2001-2006. regression analysis was used to model monthly counts of gastrointestinal pathogens in fecal samples from infected patients against monthly counts of deaths from infectious and noninfectious intestinal diseases. data came from the office of national statistics (death registrations from local registrars) and from the health protection a ... | 2008 | 18826817 |
| sporicides for clostridium difficile: the devil is in the detail. | a taskforce has now been formed with representatives from the department of health's advisory committee on antimicrobial resistance and healthcare associated infection (arhai), the hospital infection society (his), the department of health (england) and the health protection agency. the aims of the arhai/his taskforce on sporicidal disinfectants are: to develop an accepted standard for laboratory testing of disinfectants which claim to have activity against c. difficile spores; to develop a netw ... | 2011 | 21277650 |
| descriptive study of selected healthcare-associated infections using national hospital episode statistics data 1996-2006 and comparison with mandatory reporting systems. | summary: using hospital episode statistics (hes) data from england for the period 1996-2006, we performed a descriptive study to compare records of clostridium difficile for inpatients aged >or=65 years and for all patients following any of four types of orthopaedic procedures. results showed that infection rates for c. difficile increased whereas rates for orthopaedic surgical site infections (ssis) decreased. both types of infection were more common in older female patients and in patients wit ... | 2008 | 18849092 |
| distribution and antimicrobial susceptibility patterns of clostridium difficile pcr ribotypes in english hospitals, 2007-08. | a surveillance study designed to provide a representative sample of the strains of clostridium difficile causing infections in hospitals in england was in operation from april 2007 to the end of march 2008. six hundred and seventy-seven isolates were obtained from 186 hospitals in the nine geographical regions of england as recognised by the health protection agency's regional microbiology network. typing studies revealed that pcr ribotype 027 is now the most common strain isolated from symptoma ... | 2008 | 18926105 |
| genetic characterisation of clinical isolates of clostridium difficile using an optimised rapd protocol and pcr ribotyping reveals strain diversity between two tertiary referral trusts in the west midlands, uk. | epidemiological investigations of clostridium difficile often focus on differences between separate geographical areas. in this investigation, two populations of c. difficile recovered from separate tertiary referral trusts within the west midlands, uk, were characterised using both pcr ribotyping and an optimised rapd protocol. the pcr ribotyping and rapd methodologies identified differences between the two c. difficile populations, both in the prevalence and the diversity of types identified. ... | 2011 | 21511887 |
| seasonal variation of enteric infections and inflammatory bowel disease. | | 2009 | 18942760 |
| infection control. a clean bill of health. | lat year the health commission detailed findings that contributed to two infection outbreaks at the kent trust. c difficile rates within the trust in the first quarter of this year were 73 per cent lower than in 20007 plans to set up a 200-strong patient council to give feedback to the board are underway. the trust is projecting a financial deficit of pound 3.8m for the current year. staff recruitment has been largely unaffected by the bad publicity and changes within the organisation. | 2008 | 18975411 |
| accounting for regression-to-the-mean in tests for recent changes in institutional performance: analysis and power. | recent changes in individual units are often of interest when monitoring and assessing the performance of healthcare providers. we consider three high profile examples: (a) annual teenage pregnancy rates in english local authorities, (b) quarterly rates of the hospital-acquired infection clostridium difficile in national health service (nhs) trusts and (c) annual mortality rates following heart surgery in new york state hospitals. increasingly, government targets call for continual improvements, ... | 2009 | 19358144 |
| medical staff at a london district hospital are not chronic vectors of mrsa or clostridium difficile. | | 2009 | 19362741 |
| clostridium difficile ribotypes 027 and 106: clinical outcomes and risk factors. | the present study investigates risk factors for onset of clostridium difficile-associated diarrhoea, specific ribotype and environmental spore contamination in a district general hospital in south east england. c. difficile isolates were ribotyped from 97 diarrhoeal cases, following detection of c. difficile toxin from faecal specimens by enzyme immunoassay (health protection agency, southampton). the isolates were tested for various antimicrobial susceptibilities by e-test. cases were assessed ... | 2009 | 19386381 |
| lessons from stoke mandeville. | | 2006 | 17077764 |
| improvement targets for c difficile must be valid. | | 2007 | 17413147 |
| clostridium difficile: how much do hospital staff know about it? | the aim of this study was to determine the awareness of clostridium difficile infection amongst healthcare professionals. | 2009 | 19558760 |
| deaths involving clostridium difficile: england and wales, 2008. | | 2009 | 19774833 |
| screens address side room shortage. | with side rooms in ever shorter supply across nhs hospitals, the department of health has developed an ingenious portable isolation unit that can be rapidly assembled around the bed of patients suffering infections such as those caused by mrsa and clostridium difficile to help prevent cross-infection and simultaneously help reduce bed blocking. recent trials at the university college hospital in london (uclh), alongside a range of isolation screens, saw the various systems evaluated by clinician ... | 2009 | 19911555 |
| historical and changing epidemiology of healthcare-associated infections. | this review compares the historical perspectives on healthcare-associated infections (hcais) with the current changing epidemiological picture as it relates to these infections. evidence in support of these changes is given using trends in mortality for clostridium difficile and meticillin-resistant staphylococcus aureus bacteraemia in england as examples. the impact of current intervention programmes which target these, and other hcais, is also considered and knowledge gaps and options for chan ... | 2009 | 19925942 |
| four country healthcare-associated infection prevalence survey: pneumonia and lower respiratory tract infections. | in 2006, the hospital infection society was funded by the respective health services in england, wales, northern ireland and the republic of ireland to conduct a prevalence survey of healthcare-associated infection (hcai). here, we report the prevalence of pneumonia and lower respiratory tract infection other than pneumonia (lrtiop) in these four countries. the prevalence of all hcais was 7.59% (5743 out of 75 694). nine hundred (15.7%) of these infections were pneumonia, and 402 (7.0%) were lrt ... | 2010 | 20153552 |
| what has made the difference? | | 2010 | 20381899 |
| reducing clostridium difficile infection in acute care by using an improvement collaborative. | in 2006, despite a focus on infection control, salford royal had the fourth highest rate of clostridium difficile infection in north west england. | 2010 | 20659985 |
| antibiotic prophylaxis. mrsa and clostridium difficile are falling. | | 2010 | 20663825 |
| outcomes of patients who develop symptomatic clostridium difficile infection after solid organ transplantation. | clostridium difficile-associated diarrhea is the most common cause of hospital-associated diarrhea in the uk. infection can produce a spectrum of manifestations from mild diarrhea to toxic megacolon, colonic perforation, and death. the aim of this study was to evaluate the outcomes of patients who developed symptomatic clostridium difficile infection (cdi) within the first year after solid organ transplantation. between 2004 and 2007, we performed 682 transplantation: 433 from deceased-donor kid ... | 2010 | 20832558 |
| epidemiology of community-onset clostridium difficile infection in a community in the south of england. | clostridium difficile infection (cdi) has traditionally been considered a hospital acquired infection but there are a rising number of infections in the community. this study estimates the prevalence of community-onset cdi (co-cdi), defined as onset of symptoms in a community setting and outside the hospital, and examines the risk factors for co-cdi in 2-64 year-olds. | 2010 | 20869672 |
| the continuing crisis in antibiotic resistance. | the emergence of antibiotic resistance in bacterial pathogens is an inevitable consequence of antibiotic use. despite repeated warnings, negligent antibiotic use and poor infection-control practice have led to the continuing development of extensive resistance problems worldwide. multidrug-resistant pathogens are now characterized by their heterogeneity, increasing virulence, resistance even to reserve agents and spread within and between hospitals and the community. examples are glycopeptide-re ... | 2010 | 21129629 |
| contribution of a government target to controlling clostridium difficile in the nhs in england. | the introduction of mandatory surveillance of clostridium difficile infection (cdi) in 2004 showed the scale of the challenge: cases in patients >64 years old reached 55,681 in 2006. the first type 027 outbreaks had been in 2005 and cdi was a headline issue. the prevention and control of cdi requires a tripartite partnership between clinicians, health service managers, and the government/department of health which needs to set standards, ensure that cdi is a priority, set targets and monitor out ... | 2010 | 21182972 |
| multiple component patient safety intervention in english hospitals: controlled evaluation of second phase. | to independently evaluate the impact of the second phase of the health foundation's safer patients initiative (spi2) on a range of patient safety measures. design a controlled before and after design. five substudies: survey of staff attitudes; review of case notes from high risk (respiratory) patients in medical wards; review of case notes from surgical patients; indirect evaluation of hand hygiene by measuring hospital use of handwashing materials; measurement of outcomes (adverse events, mort ... | 2011 | 21292720 |
| ward-based rather than team-based junior surgical doctors reduce mortality for patients with a fracture of the proximal femur: results from a two-year observational study. | we performed a retrospective study of a departmental database to assess the efficacy of a new model of orthopaedic care on the outcome of patients with a fracture of the proximal femur. all 1578 patients admitted to a university teaching hospital with a fracture of the proximal femur between december 2007 and december 2009 were included. the allocation of foundation doctors years 1 and 2 was restructured from individual teams covering several wards to pairs covering individual wards. no alterati ... | 2011 | 21357963 |
| increased health burden associated with clostridium difficile diarrhoea in patients with inflammatory bowel disease. | background  clostridium difficile (c. difficile) infection in hospitals in developed countries continues to be a major public health hazard despite increased control measures including review of antibiotic policies and hygiene measures. patients with colitis are thought to be particularly vulnerable to c. difficile associated diarrhoea (cdad). identifying the clinical burden among hospitalised patients admitted with inflammatory bowel disease is an essential first step towards identifying and tr ... | 2011 | 21517920 |
| impact of changes in clostridium difficile diagnostic testing on detection of c. difficile infection and all england mandatory surveillance data. | following the report of the centre for evidence-based purchasing, which suggested poor performance of clostridium difficile testing kits, revised guidance was issued by the department of health (england) recommending a two-test algorithm. the aim of this study was to survey english national health service (nhs) diagnostic microbiology laboratories using an electronic questionnaire to investigate changes in laboratory procedures in response to the guidance and model the impact these changes had o ... | 2011 | 21764171 |
| diagnostic testing for clostridium difficile: a comprehensive survey of laboratories in england. | recent studies have shown poor performance of commonly used toxin enzyme immunoassays (eias) for laboratory testing for clostridium difficile infection (cdi). in 2009-2010, the uk health protection agency and the european society of clinical microbiology and infectious diseases stated that toxin eia testing alone is suboptimal, and recommended a two-step testing protocol (i.e. screening with one method and confirming the results with another method). all acute english national health service tru ... | 2011 | 21724296 |
| impact of guidelines and enhanced antibiotic stewardship on reducing broad-spectrum antibiotic usage and its effect on incidence of clostridium difficile infection. | objectives to evaluate the impact of an 'intervention' consisting of revised antibiotic guidelines for empirical treatment of common infections and enhanced stewardship on reducing broad-spectrum antibiotic usage and its effect on incidence of clostridium difficile infection (cdi). methods this was a retrospective, quasi-experimental study using interrupted time series (its) over 12 months before and after the intervention. the setting was adult medical and surgical wards in university hospital ... | 2011 | 21676904 |
| co-morbidities as predictors of mortality in clostridium difficile infection and derivation of the arc predictive score. | clostridium difficile associated diarrhoea (cdad) has increased significantly in the last 15 years, but predictors of outcome are inadequately understood. this was a cohort study of 2761 patients in north east england between 2002 and 2009, with the end-point of mortality at 30 days. the role of age, gender and co-morbidities was examined by binary logistic regression. rounded odds ratios were used to develop a predictive score. a predictive score based on age, renal disease and cancer (arc scor ... | 2011 | 22047977 |
| Molecular epidemiology of Clostridium difficile strains in children compared with that of strains circulating in adults with Clostridium difficile-associated infection. | Molecular analysis of Clostridium difficile (28 isolates) from children (n = 128) in Oxfordshire, United Kingdom, identified eight toxigenic genotypes. Six of these were isolated from 27% of concurrent adult C. difficile-associated infections studied (n = 83). No children carried hypervirulent PCR ribotype 027. Children could participate in the transmission of some adult disease-causing genotypes. | 2011 | 21940476 |
| novel fit for purpose single use tourniquet: best of both worlds. | healthcare associated infections (hai), such as meticillin resistant staphylococcus aureus (mrsa) and clostridium difficile (c. diff) are estimated to cost the nhs pound1 billion and contribute to 5000 deaths/year in the uk. to date the main emphasis to reduce hais has been on hand hygiene. however environmental microbial load and compliance limits the efficacy of hand washing alone. cultures from tourniquets have demonstrated contamination by pathogens including mrsa. consequently, many uk trus ... | 2009 | 19517293 |
| c. difficile infection - a tool for improving practice and reducing rates. | clostridium difficile infection (cdi) is a recognized health-care-acquired infection (hai) and as such it is vital that hospitals do more to reduce the rates of infection. patients, especially older people, become particularly susceptible to cdi after treatment with antibiotics. mention of cdi on death certificates is increasing and surveillance, especially when accompanied by feedback to clinicians, has long been established as an effective tool to lower hais. in february 2008, a manchester hos ... | 2009 | 19525909 |
| establishment of an outpatient and home parenteral antimicrobial therapy service at a london teaching hospital: a case series. | outpatient and home parenteral antimicrobial therapy (ohpat) is becoming increasingly commonplace in the uk, enabling those patients who would previously have been obliged to remain in hospital for intravenous treatment to be managed as outpatients or in their own homes. the ohpat service at st mary's hospital, london, was established in 2004. this paper describes the types of infection, antimicrobial management and outcomes of patients referred to the service in the 3.5 years since its inceptio ... | 2009 | 19549671 |