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Characterizing Hospital-Associated Clostridioides difficile Infection: A Retrospective Descriptive Review and Bed Tracing Analysis

Daniels, Kellie (2024) Characterizing Hospital-Associated Clostridioides difficile Infection: A Retrospective Descriptive Review and Bed Tracing Analysis. Master Essay, University of Pittsburgh.

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Description of problem: Clostridioides difficile is a common hospital-associated infection that is defined as an urgent threat to public health by the CDC (CDC, 2019). Risk of C. difficile infection (CDI) is highest in elderly and immunocompromised individuals, as well as those with recent antibiotic exposure and frequent or prolonged hospitalization. This essay aims to analyze an increase in hospital-associated CDI (HA-CDI) cases in an urban, acute care hospital from June 2022 – August 2023.
Aims: 1) Characterize and describe HA-CDI patients to identify trends, exposures, and risk factors among these patients. 2) Analyze the movement of HA-CDI patients to determine if shared environments or exposure to other infected patients may have contributed to transmission in the hospital setting.
Methods: Data was collected from the electronic health records of HA-CDI patients during the study period, including risk factors, testing, demographics, and admissions information. Variables were assessed for their frequency and significance among these patients. Contact tracing was performed to determine if shared environments may have contributed to transmission and identify plausible exposures between patients.
Results: This study included 48 patients with 50 reported cases of HA-CDI. Antibiotics were the most common risk factor exposure (88.0%). Patients were found to be younger but with more severe comorbidities than expected. There was a significant relationship identified between enteric tube insertion and toxin positivity. Contact tracing revealed that 83.3% of patients had at least one plausible exposure to another HA-CDI patient on the same unit preceding infection. Shared rooms were not implicated as common sources of transmission.
Conclusions: Hand hygiene, adherence to transmission-based precautions, and thorough cleaning practices are vital to the prevention of HA-CDI. Adherence to testing protocol may reduce unnecessary CDI testing. The significant relationship between enteric tubes and toxin positivity requires further study but may highlight a risk of infection during tube insertion or manipulation.
Public Health Significance: Findings from this study will inform infection prevention practices at the facility of study. Understanding HA-CDI risk factors specific to this facility allows for identification of at-risk patients and the implementation of targeted interventions to reduce the incidence of CDI and HA-CDI.


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Item Type: Other Thesis, Dissertation, or Long Paper (Master Essay)
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Daniels, Kellieked160@pitt.eduked160
ContributionContributors NameEmailPitt UsernameORCID
Committee ChairYassin, Mohamed Hyassinm@upmc.eduUNSPECIFIEDUNSPECIFIED
Committee MemberGivens, David Ldlg43@pitt.edudlg43UNSPECIFIED
Committee MemberHildebrand, Barbarahildebrandbr@upmc.eduUNSPECIFIEDUNSPECIFIED
Date: 17 May 2024
Date Type: Completion
Submission Date: 19 April 2024
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 67
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Infectious Diseases and Microbiology
Degree: MPH - Master of Public Health
Thesis Type: Master Essay
Refereed: Yes
Uncontrolled Keywords: Clostridioides difficile, Infection Prevention, HAI, Infectious Disease, Hospital-associated infection
Date Deposited: 17 May 2024 21:17
Last Modified: 17 May 2024 21:17


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