文章基本信息

标题：Surveillance of Clostridium difficile infections in a long-term care psychogeriatric facility: outbreak analysis and policy improvement
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作者：Gretel Van Esch ; Johan Van Broeck ; Michel Delmée 等
期刊名称：Archives of Public Health
印刷版ISSN：0778-7367
电子版ISSN：0778-7367
出版年度：2015
卷号：73
期号：1
页码：18
DOI：10.1186/s13690-015-0067-y
语种：English
出版社：BioMed Central
摘要：Following an exceptionally high Clostridium difficile infections (CDI) incidence (Spring 2011) in a psychogeriatric long-term care facility, a bidirectional study (2009–2012) was initiated to identify determinants (retrospectively) and to assess intervention measures taken (prospectively). For every CDI patient (de novo cases, relapses, and recurrences), a control patient (patient in the opposite room) was selected and risk factor analysis performed. Following the epidemic peak a more stringent hygienic protocol and surveillance program were implemented, as well as uniform guidelines for metronidazole and vancomycin prescription. The nutritional state (total protein/prealbumine) significantly differed between the CDI group (poorer nutritional state at admission) and the control group, and also antibiotic use (general) could be confirmed as a risk factor. A multi-disciplinary nutritional team has been established in order to improve the nutritional balance of our patients. Aside from stringent hygiene and antibiotic prescription stewardship, malnutrition of patients is a factor to be taken into account to contain a CDI outbreak in a long term care facility (LTCF).
关键词：Clostridium difficile ; Intervention ; Nutritional status ; LTCF