Evaluation and Research on Antimicrobial Stewardship's Effect on Clostridium difficile (ERASE C. difficile) Project. Toolkit for Reduction of Clostridium difficile through Antimicrobial Stewardship.

摘要

Clostridium difficile infection (C. difficile) is a serious public health problem that has recently increased in both incidence and severity. Centers for Disease Control and Prevention (CDC) surveillance data show that U.S. hospital discharges with C. difficile doubled between 2000 and 2003 and rates are highest in the northeastern United States. Persons over age 65 years have been most affected, but recent changes in epidemiology suggest that lower risk populations, including healthy postpartum women and community dwellers with no recent healthcare contact or antimicrobial exposures, may also be affected. Further, there are indications of recent increases in the severity of C. difficile, including increased complications and C. difficile-related mortality. In addition to advanced age, the major risk factors for C. difficile are exposure to antimicrobials and hospitalization. Studies have found major costs associated with C. difficile, such as longer inpatient lengths of stay, and a significant increase in costs both for inpatient care and at 180 days after the initial hospitalization when the C. difficile occurred. Taking steps to reduce C. difficile is a major health and public health imperative. Twenty-seven States and the District of Columbia now require reporting of healthcare-associated infections to the National Healthcare Safety Network (NHSN). Moreover, CDCs NHSN created a reporting module for C. difficile as part of its Patient Safety Component to encourage infection surveillance or laboratory-identified event reporting across hospitals nationwide.