Download or read book Effectiveness of Early Diagnosis Prevention and Treatment of Clostridium Difficile Infection written by and published by . This book was released on with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Effectiveness of Early Diagnosis Prevention and Treatment of Clostridium Difficile Infection written by U. S. Department of Health and Human Services and published by CreateSpace. This book was released on 2013-04-06 with total page 266 pages. Available in PDF, EPUB and Kindle. Book excerpt: Clostridium difficile infection (CDI) is a serious healthcare-associated infection and a growing health care problem. C. difficile is a Gram-positive, spore-forming, anaerobic bacterium that, when ingested, can cause CDI if it is a toxigenic strain. CDI symptoms include varying levels of diarrhea severity, as well as pseudomembranous colitis and toxic megacolon. CDI incidence is estimated at 6.5 cases per 10,000 patient days in hospital. About 250,000 hospitalizations were associated with CDI in 2005. Direct attributable mortality from CDI has been reported to be as high as 6.9 % of cases. Elderly people in hospitals account for the vast majority of severe morbidity and mortality. Residents of long-term care facilities are also at higher risk. Incidence rates may increase by fourfold or fivefold during outbreaks. In addition to institutional care environments, C. difficile is also common in the community, being easily isolated from soil and water samples. Community-associated CDI rates are generally much lower, accounting for 27 % of all CDI cases in a recent prevalence study, but are also on the rise. However, the source of the C. difficile organisms responsible for cases of CDI in the community is not well understood. In order for CDI to develop, a person must be infected with a strain of C. difficile capable of making toxin in the person's colon. Approximately 1–2 % of healthy individuals are colonized with C. difficile. If these people have usual, healthy colonic flora, the risk of CDI is very low. There is a small risk of CDI if the colon flora becomes disturbed, commonly through antibiotic use, while the person is colonized with a toxigenic strain. Antibiotics that disturb colon flora enough to allow CDI to develop must get into the colon, and they are associated with alterations in relative amounts of colon bacterial constituents. The immune status of the patient also contributes to the risk of developing CDI and the experienced severity. Other risk factors include increasing age, female gender, comorbidities, gastrointestinal procedures, and use of gastric acid suppression medications. Risk profiles for recurrent CDI are similar. One study, which statistically modeled CDI within the hospital setting, suggested that reducing patient susceptibility to infection is more effective in reducing CDI cases than lowering transmission rates. The purpose of this systematic review was to provide an overarching assessment of the evidence for comparing the accuracy of diagnostic tests and the effectiveness of prevention and treatment interventions on initial and recurrent CDI-related patient outcomes in adult patients. The major impetus of this review is the presence of clinical disease, not asymptomatic carriage of the C. difficile organism. The review focuses on adult patients because adults, and particularly elderly adults, carry the large majority of the morbidity and mortality burden. The following Key Questions (KQs) form the basis for this review: KQ 1. How do different methods for detection of toxigenic C. difficile to assist with diagnosis of CDI compare in their sensitivity and specificity? Do the differences in performance measures vary with sample characteristics? KQ 2. What are effective prevention strategies? What is the effectiveness of current prevention strategies? What are the harms associated with prevention strategies? How sustainable are prevention practices in health care (outpatient, hospital inpatient, extended care) and community settings? KQ 3. What are the comparative effectiveness and harms of different antibiotic treatments? Does effectiveness vary by disease severity or strain? Does effectiveness vary by patient characteristics: age, gender, comorbidity, hospital- versus community-acquired setting? How do prevention and treatment of CDI affect resistance of other pathogens? KQ 4. What are the effectiveness and harms of nonstandard adjunctive interventions? In patients with relapse/recurrent CDI?

Download or read book Future Research Needs for Prevention and Treatment of Clostridium Difficile Infection written by Hussein Z. Noorani and published by . This book was released on 2012 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Clostridium difficile infection (CDI) is a serious healthcare-associated infection and a growing health care problem, especially with the emergence of more virulent strains in the early 2000s. CDI is now the most common cause of nosocomial infectious diarrhea and is increasing in incidence and, in all likelihood, severity. A comparative effectiveness review (CER) was prepared by the Minnesota Evidence-based Practice Center (EPC) on Comparative Effectiveness of Early Diagnosis, Prevention, and Treatment of Clostridium difficile Infection (December 2011). The purpose of the CER was to provide an overarching assessment of the evidence for comparing the accuracy of diagnostic tests and the effectiveness of prevention and treatment interventions on initial and recurrent CDI-related patient outcomes in adults. Limited high-quality evidence was available to support the diagnostic, preventive, and treatment practices for CDI carried out by providers in hospital, long-term care, and outpatient settings. Inconsistency in definitions of diarrhea, severity, resolution of symptoms, recurrence, or cure contributed to the difficulty in drawing conclusions from the evidence. There were a number of important evidence gaps identified in the CER. The objective of this Future Research Needs project was to systematically prioritize evidence gaps on prevention and treatment of CDI, and to develop a list of research questions to address the prioritized gaps. Although different diagnostic methods for toxigenic Clostridium difficile were evaluated in the CER, diagnostic methods were not included in this project primarily because polymerase chain reaction testing is rapidly becoming the standard diagnostic test for the infection.

Download or read book Early Diagnosis Prevention and Treatment of Clostridium Difficile written by Mary Butler and published by . This book was released on 2016 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: OBJECTIVE: Update a 2011 review of differences in accuracy of diagnostic tests and the effects of interventions to prevent and treat Clostridium difficile infection (CDI) in adults. DATA SOURCES: Medline(r), the Cochrane Clinical Trials Registry, and Embase(r) from 2010 through April 2015 plus reference lists of included studies and recent systematic reviews. METHODS: Two investigators screened abstracts and full texts of identified references for eligibility. Eligible studies included studies of sensitivity and specificity for diagnostic tests in patients at risk for CDI. We included randomized controlled trials or high-quality cohort studies enrolling adult patients with CDI or suspected CDI for treatment interventions. Prevention studies also included adult patients at risk for CDI and observational study designs. Two investigators extracted data, assessed individual study risk of bias, and evaluated the strength of evidence for each comparison and outcome. Pooled estimates were analyzed to assess the efficacy and comparative effectiveness of a variety of treatments. RESULTS: We identified 37 diagnostic studies and 56 studies evaluating prevention or treatment interventions to update the review. High-strength evidence showed that nucleic amplification tests were sensitive and specific for CDI when using culture as the reference standard. Low-strength evidence was found that some institutional prevention interventions, such as antibiotic prescribing practices and transmission interruption (terminal room cleaning with hydrogen peroxide vapor and handwashing campaigns), reduce CDI incidence. Low-strength evidence also suggested that prevention programs can be sustained over several years. For CDI treatment, vancomycin is more effective than metronidazole (high-strength evidence), and the effect does not vary by severity (moderate-strength evidence). Fidaxomicin remains noninferior to vancomycin for the initial cure of CDI (moderate-strength evidence) but is superior to vancomycin for prevention of recurrent CDI (now high-strength evidence). Although both fecal microbiota transplantation (FMT) and probiotics were the subject of a significant number of new studies, the overall high risk of bias of many of these studies necessitated ratings of low strength of evidence. Specifically, low-strength evidence suggests that FMT may have a significant effect on reducing recurrent CDI. Similarly, low-strength evidence suggests that lactobaccilus strains and multiorganism probiotics also can reduce recurrent CDI. However, Saccharomyces boulardii was no more effective than placebo in preventing recurrent CDI. Evidence for FMT for refractory CDI was insufficient. Few studies reported adverse events; when reported, few events were noted. CONCLUSIONS: Research on diagnostic testing for and interventions to treat CDI expanded considerably in 4 years. Nucleic acid amplification tests have high sensitivity and specificity for CDI. Vancomycin is more effective than metronidazole for initial CDI, while fidaxomicin is more effective than vancomycin for the prevention of recurrent CDI. FMT and lactobacillus probiotics to restore colonic biodiversity and improve patient resistance to CDI or recurrence have low-strength but relatively consistent positive evidence for efficacy.

Download or read book Future Research Needs for Prevention and Treatment of Clostridium Difficile Infection written by U. S. Department of Health and Human Services and published by CreateSpace. This book was released on 2013-04-04 with total page 66 pages. Available in PDF, EPUB and Kindle. Book excerpt: Clostridium difficile infection (CDI) is a serious healthcare-associated infection and a growing health care problem, especially with the emergence of more virulent strains in the early 2000s. Clostridium difficile was first recognized as having the ability to cause pseudomembranous colitis in the late 1970s. CDI is now the most common cause of nosocomial infectious diarrhea. Asymptomatic colonization in healthy adults has been observed in only 3 percent of persons, while the prevalence of such colonization among residents in long-term-care facilities approaches 50 percent. Individuals colonized with Clostridium difficile serve as a reservoir for infection by contaminating the environment with Clostridium difficile spores, thus leading to the spread of the organism on the hands of health care workers or via use of medical equipment. CDI is increasing in incidence and, in all likelihood, severity. The number of cases diagnosed among patients discharged from hospitals increased from 31 per 100,000 persons in 1996 to 84 per 100,000 persons in 2005. Infection due to a relatively new strain of Clostridium difficile, termed “North American pulsed-field gel electrophoresis type 1” (NAP1), is felt to be at least partially responsible for this increased incidence of CDI as well as for the increased severity of clinical illness. The NAP1 strain is capable of producing more than 15 times the quantity of both toxins A and B, which are directly responsible for the damage to the intestinal tract of infected patients. Hence, CDI is not only now more common, but also more severe, leading to an attributable mortality of up to 16 percent of all deaths. A comparative effectiveness review (CER) was prepared by the Minnesota Evidence-based Practice Center (EPC) on Comparative Effectiveness of Early Diagnosis, Prevention, and Treatment of Clostridium difficile Infection (December 2011). The purpose of the CER was to provide an overarching assessment of the evidence for comparing the accuracy of diagnostic tests and the effectiveness of prevention and treatment interventions on initial and recurrent CDI related patient outcomes in adults. Key informants, provided input to the EPC on the scope of the CER, agreed that its greatest contribution to the field could be to have an independent organization provide a comprehensive review of the major concerns of the field for both clinicians and researchers. The major impetus underlying the SR was a concern about the presence of clinical disease, not asymptomatic carriage of the Clostridium difficile organism.1 Molecular epidemiological studies whose main purpose was to identify the strains of Clostridium difficile present in the population were outside the scope of the CER. The CER focused on adult patients as they, particularly elderly adults, carry the most of the morbidity and mortality burden.The CER addressed the following Key Questions (KQs): 1. How do different methods for detection of toxigenic Clostridium difficile to assist with diagnosis of CDI compare in their sensitivity and specificity? a. Do the differences in performance measures vary with sample characteristics? 2. What are effective prevention strategies? a. What is the effectiveness of current prevention strategies? b. What are the harms associated with prevention strategies? c. How sustainable are prevention practices in health care (outpatient, hospital inpatient, extended care) and community settings? 3. What are the comparative effectiveness and harms of different antibiotic treatments? a. Does effectiveness vary by disease severity or strain? b. Does effectiveness vary by patient characteristics: age, gender, comorbidity, hospital versus community-acquired setting? c. How do prevention and treatment of CDI affect resistance of other pathogens? 4. What are the effectiveness and harms of nonstandard adjunctive interventions? a. In patients with relapse/recurrent CDI?

Download or read book Chalk Talks in Internal Medicine written by Somnath Mookherjee and published by Springer Nature. This book was released on 2020-09-30 with total page 347 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book provides teaching scripts for medical educators in internal medicine and coaches them in creating their own teaching scripts. Every year, thousands of attending internists are asked to train the next generation of physicians to master a growing body of knowledge. Formal teaching time has become increasingly limited due to rising clinical workload, medical documentation requirements, duty hour restrictions, and other time pressures. In addition, today’s physicians-in-training expect teaching sessions that deliver focused, evidence-based content that is integrated into clinical workflow. In keeping with both time pressures and trainee expectations, academic internists must be prepared to effectively and efficiently teach important diagnostic and management concepts. A teaching script is a methodical and structured plan that aids in effective teaching. The teaching scripts in this book anticipate learners’ misconceptions, highlight a limited number of teaching points, provide evidence to support the teaching points, use strategies to engage the learners, and provide a cognitive scaffold for teaching the topic that the teacher can refine over time. All divisions of internal medicine (e.g. cardiology, rheumatology, and gastroenterology) are covered and a section on undifferentiated symptom-based presentations (e.g. fatigue, fever, and unintentional weight loss) is included. This book provides well-constructed teaching scripts for commonly encountered clinical scenarios, is authored by experienced academic internists and allows the reader to either implement them directly or modify them for their own use. Each teaching script is designed to be taught in 10-15 minutes, but can be easily adjusted by the reader for longer or shorter talks. Teaching Scripts in Internal Medicine is an ideal tool for internal medicine attending physicians and trainees, as well as physician’s assistants, nurse practitioners, and all others who teach and learn internal medicine.

Download or read book The ASCRS Manual of Colon and Rectal Surgery written by David E. Beck and published by Springer Science & Business Media. This book was released on 2009-06-12 with total page 1042 pages. Available in PDF, EPUB and Kindle. Book excerpt: The ASCRS Textbook of Surgery of the Colon and Rectum offers a comprehensive textbook designed to provide state of the art information to residents in training and fully trained surgeons seeking recertification. The textbook also supports the mission of the ASCRS to be the world’s authority on colon and rectal disease. The combination of junior and senior authors selected from the membership of the ASCRS for each chapter will provide a comprehensive summary of each topic and allow the touch of experience to focus and temper the material. This approach should provide the reader with a very open minded, evidence based approach to all aspects of colorectal disease. Derived from the textbook, The ASCRS Manual of Surgery of the Colon and Rectum offers a “hands on” version of the textbook, written with the same comprehensive, evidence-based approach but distilled to the clinical essentials. In a handy pocket format, readers will find the bread and butter information for the broad spectrum of practice. In a consistent style, each chapter outlines the condition or procedure being discussed in a concise outline format – easy to read, appropriately illustrated and referenced.

Download or read book Emerging Transplant Infections written by Michele I. Morris and published by Springer. This book was released on 2021-06-22 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: The field of transplant medicine has evolved significantly since the first kidney transplant was performed in 1954. Innovations in transplant immunosuppression have lowered the risk of organ rejection so that infectious complications are now the leading cause of hospitalization and mortality after solid organ transplant. Infection is also cited as the leading cause of non-relapse mortality after stem cell transplantation. As transplant centers have recognized the importance of transplant specific expertise in patient outcomes, the field of transplant infectious diseases has expanded into a recognized and highly valued subspecialty. International growth in solid organ and stem cell transplantation has outpaced access to such expertise, with some centers employing microbiology laboratory directors and transplant nephrologists as their lead infectious diseases consultants. This has been a particular challenge as the use of novel immunosuppressive regimens in new geographic and immigrant populations have fueled the emergence of new infection syndromes, with the initial presentation sometimes occurring in this most vulnerable patient population. This digital-first book is designed to meet the needs of practitioners engaged in transplant infectious disease practice who need more depth than they are able to find in UpToDate. It provides an overview of emerging infectious disease challenges with clinically relevant information regarding the epidemiology, diagnosis, management, and prevention of infections in solid organ and stem cell transplant recipients. Each chapter focuses on a clinical syndrome or pathogen with new or emerging implications for transplant patients. Given the rapidly evolving nature of emerging infections and topics in transplant infections, no resource has been published on these increasingly notorious issues; this this text is written by top, global experts who regularly update the material to ensure that readers will always have access to the most cutting edge material available. The editorial team consists of three experienced leaders in the field, all of whom have a strong record of scholarship and publication, as well as an international reputation. All three have focused their academic careers on emerging infectious diseases in transplantation, including a current and a past president of various infectious diseases and transplantation societies. The editors are also experienced reviewers and authors who have collaborated on multiple previous projects. All are committed to this project as a unique opportunity to make an important contribution to their field.

Download or read book Infectious Diseases in the Intensive Care Unit written by Manish Soneja and published by Springer. This book was released on 2021-08-02 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Infections in intensive care is a very broad topic, and this book provides concise yet comprehensive coverage. It focuses on the appropriate and judicious use of microbiological, radiological and point-of-care tests in diagnostic work-ups and evidence-based management protocols. Moreover, it offers essential information on the diagnosis and management of commonly encountered infections in the intensive care unit, making it a handy ready-reference manual for intensivists.

Download or read book Guideline for Isolation Precautions in Hospitals written by Julia S. Garner and published by . This book was released on 1983 with total page 80 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Principles and Practice of Pediatric Infectious Diseases written by Sarah S. Long and published by Saunders. This book was released on 2008 with total page 1618 pages. Available in PDF, EPUB and Kindle. Book excerpt: "In print, online, or on your mobile device, Principles and Practice of Pediatric Infectious Disease provides the comprehensive and actionable coverage you need to understand, diagnose, and manage the ever-changing, high-risk clinical problems caused by infectious diseases in children and adolescents. With new chapters, expanded and updated coverage, and increased worldwide perspectives, this authoritative medical reference offers the latest need-to-know information in an easily-accessible, high-yield format for quick answers and fast, effective intervention!"--Publisher's website.

Download or read book Manual of Childhood Infections written by Mike Sharland and published by Oxford University Press, USA. This book was released on 2011-04-07 with total page 913 pages. Available in PDF, EPUB and Kindle. Book excerpt: This manual gives information on the causative organisms, epidemiology and clinical features of all important childhood infections. It includes guidance on the clinical management of the infections and on steps to be taken to prevent future cases.

Download or read book Evidence Based Critical Care written by Robert C. Hyzy and published by Springer. This book was released on 2017-05-30 with total page 805 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book provides learners with a unique opportunity by virtue of the format outlined above. Each case presentation has a case vignette, which leads up to an important clinical question, and is followed by additional discussion which resolves the question posed. This is a new way to present knowledge in a medical book and should help critical care practitioners, fellows, residents, allied health professionals and students expand their critical care knowledge in an efficient and effective manner. This approach should also benefit those preparing for board examinations.

Download or read book Red Book Atlas of Pediatric Infectious Diseases written by American Academy of Pediatrics and published by . This book was released on 2007 with total page 440 pages. Available in PDF, EPUB and Kindle. Book excerpt: Based on key content from Red Book: 2006 Report of the Committee on Infectious Diseases, 27th Edition, the new Red Bookr Atlas is a useful quick reference tool for the clinical diagnosis and treatment of more than 75 of the most commonly seen pediatric infectious diseases. Includes more than 500 full-color images adjacent to concise diagnostic and treatment guidelines. Essential information on each condition is presented in the precise sequence needed in the clinical setting: Clinical manifestations, Etiology, Epidemiology, Incubation period, Diagnostic tests, Treatment

Download or read book CDC Yellow Book 2018 Health Information for International Travel written by Centers for Disease Control and Prevention CDC and published by Oxford University Press. This book was released on 2017-04-17 with total page 672 pages. Available in PDF, EPUB and Kindle. Book excerpt: THE ESSENTIAL WORK IN TRAVEL MEDICINE -- NOW COMPLETELY UPDATED FOR 2018 As unprecedented numbers of travelers cross international borders each day, the need for up-to-date, practical information about the health challenges posed by travel has never been greater. For both international travelers and the health professionals who care for them, the CDC Yellow Book 2018: Health Information for International Travel is the definitive guide to staying safe and healthy anywhere in the world. The fully revised and updated 2018 edition codifies the U.S. government's most current health guidelines and information for international travelers, including pretravel vaccine recommendations, destination-specific health advice, and easy-to-reference maps, tables, and charts. The 2018 Yellow Book also addresses the needs of specific types of travelers, with dedicated sections on: · Precautions for pregnant travelers, immunocompromised travelers, and travelers with disabilities · Special considerations for newly arrived adoptees, immigrants, and refugees · Practical tips for last-minute or resource-limited travelers · Advice for air crews, humanitarian workers, missionaries, and others who provide care and support overseas Authored by a team of the world's most esteemed travel medicine experts, the Yellow Book is an essential resource for travelers -- and the clinicians overseeing their care -- at home and abroad.

Download or read book Probiotics and Child Gastrointestinal Health written by Stefano Guandalini and published by Springer. This book was released on 2019-06-17 with total page 150 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book shows the huge impact the gut microbiota has on the gastrointestinal health of humans with a particular focus on children. It also highlights the potential use of probiotic microorganisms to protect or improve children’s gastrointestinal health. Humans are not single organisms: We are a multi-organism structure composed of ourselves and our microbiota, living in close symbiosis since birth and even before. The huge impact that the billons of microscopic cells living in our gut have on our gastrointestinal and systemic health cannot be overestimated. The enormous progress that has been made in the past decade in our still very incomplete understanding of the gut microbiota is opening the door to potential applications in human health that were simply unthinkable before. One of the most interesting aspects of this new scientific horizon is the fact that we may identify (or even create in the laboratory) and utilize many of these “friendly bacteria” to protect, or improve our health. Thus, strains of probiotic microorganisms are being identified and studied in a vast array of clinical scenarios. Among the most investigated areas for probiotics is the gastrointestinal health of children. The topics addressed in this book are spanning from the development of the gut microbiota in the fetus and newborn all the way to current and potential applications in disparate conditions such as necrotizing enterocolitis, or infectious, or inflammatory conditions affecting the child. The book is written in a rigorous, evidence based manner by an international group of outstanding experts in these fields and is aimed at pediatric gastroenterologists, pediatricians and physician scientists alike.

Download or read book Clostridium Difficile Infection in Long Term Care Facilities written by Teena Chopra and published by Springer Nature. This book was released on 2019-11-14 with total page 80 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book aims to fill knowledge gap among healthcare workers about Clostridium difficile (also known as C.difficile and CDI) among aging patients, especially those in long-term care facilities (LTCFs). Written by experts in infectious diseases and geriatric medicine, this book provides comprehensive information on all aspects of CDI pertaining to LTCF settings, including epidemiology, diagnosis, prevention, management and the unique challenges faced by LTCFs with regards to the CDI problem. The book begins by introducing the topic as it relates to aging patients before delving into the various aspects of CDI management. Topics include infection control and prevention, treatment of CDI, and the establishment of antibiotic stewardship programs to reduce inappropriate antibiotic use and reduce CDI rates. The book also features a chapter on probiotics for the prevention of CDI and new strategies to monitor environmental cleaning practices of CDI patient rooms that do not appear in any other resource. Clostridium Difficile Infection in Long-Term Care Facilities is an excellent resource for geriatricians, infectious diseases specialists, long-term care administrators, nurses, pharmacists, researchers, and all clinicians working with infections in long-term care settings.