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Institutional review of the implementation and use of a Clostridium difficile infection bundle and probiotics in adult trauma patients. Am J Surg 2018 05;215(5):825-830

Date

03/02/2018

Pubmed ID

29490870

DOI

10.1016/j.amjsurg.2018.01.005

Scopus ID

2-s2.0-85042406071

Abstract

BACKGROUND: Clostridium difficile infection (CDI) is a common cause of healthcare associated infections contributing to morbidity and mortality. Our objective was to evaluate the impact of the implementation of a CDI bundle along with probiotic utilization.

METHODS: A retrospective review of trauma admissions from 2008 to 2014 was performed. The CDI bundle was implemented in stages from 2009 through 2014 with probiotics initiated in 2010. The bundle included changes in cleaning practices, education, screening, and contact precautions.

RESULTS: 4632 (49%) patients received antibiotics with 21% receiving probiotics. Probiotic use was associated with increased age, male sex, more severely injured, and antibiotic use. CDI incidence decreased from 11.2 to 4.8 per 1000 admissions, p = .03. Among patients who received antibiotics CDI incidence decreased from 2.2% to 0.7%, p = .01.

CONCLUSIONS: We report the largest series of a CDI bundle implementation including probiotics. During the period of adoption of these interventions, the incidence of CDI decreased significantly.

Author List

Bommiasamy AK, Connelly C, Moren A, Dodgion C, Bestall K, Cline A, Martindale RG, Schreiber MA, Kiraly LN

Author

Christopher M. Dodgion MD Associate Professor in the Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Aged
Anti-Bacterial Agents
Clostridium Infections
Cross Infection
Female
Hospitalization
Humans
Incidence
Infection Control
Injury Severity Score
Length of Stay
Male
Middle Aged
Oregon
Probiotics
Retrospective Studies
Wounds and Injuries