Long term effect of infection control practices and associated factors during a major Clostridium difficile outbreak in Costa Rica
Introduction: The C. difficile BI/NAP 1 hyper virulent strain has been responsible for the nosocomial outbreaks in several countries. The present study describes the infection control strategies utilized to achieve outbreak control as well as the factors associated with a C. difficile BI/NAP 1 hyper...
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The Journal of Infection in Developing Countries
2013-12-01
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| Series: | Journal of Infection in Developing Countries |
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| Online Access: | https://jidc.org/index.php/journal/article/view/2854 |
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| author | Roy A Wong-McClure Elenita Ramírez-Salas Nury Mora-Brenes Lorena Aguero-Sandí Maritza Morera-Sigler Xiomara Badilla-Vargas Marcela Hernández-de Merzerville Michele O’Shea Elizabeth Bryce |
| author_facet | Roy A Wong-McClure Elenita Ramírez-Salas Nury Mora-Brenes Lorena Aguero-Sandí Maritza Morera-Sigler Xiomara Badilla-Vargas Marcela Hernández-de Merzerville Michele O’Shea Elizabeth Bryce |
| author_sort | Roy A Wong-McClure |
| collection | DOAJ |
| description | Introduction: The C. difficile BI/NAP 1 hyper virulent strain has been responsible for the nosocomial outbreaks in several countries. The present study describes the infection control strategies utilized to achieve outbreak control as well as the factors associated with a C. difficile BI/NAP 1 hyper virulent strain outbreak in Costa Rica.
Methodology: A descriptive analysis of the C. difficile outbreak was completed for the period of January 2007 to December 2010 in one affected hospital. An unmatched case-control study was subsequently performed to evaluate the association of exposure factors with C. difficile infection.
Results: The pattern of the outbreak was characterized by a sharp increase in the incidence rate during the initial weeks of the outbreak, which was followed by a reduction in the incidence curve as several infection control measures were implemented.
The C. difficile BI/NAP1 infection was associated with the prescription of antibiotics, in particular levofloxacin (OR: 9.3; 95%CI: 2.1-40.2), meropenem (OR: 4.9, 95%CI: 1.0-22.9), cefotaxime (OR: 4.3, 95%CI: 2.4-7.7), as well as a medical history of diabetes mellitus (OR: 2.9, 95%CI: 1.5-5.8).
Conclusions: The infection control strategies implemented proved to be effective in achieving outbreak control and in maintaining the baseline C. difficile incidence rate following it. The reported C. difficile outbreak was associated with the prescription of broad-spectrum antibiotics and a medical history of diabetes.
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| format | Article |
| id | doaj-art-179422fff7d941bbbb5e3949d5145ac2 |
| institution | OA Journals |
| issn | 1972-2680 |
| language | English |
| publishDate | 2013-12-01 |
| publisher | The Journal of Infection in Developing Countries |
| record_format | Article |
| series | Journal of Infection in Developing Countries |
| spelling | doaj-art-179422fff7d941bbbb5e3949d5145ac22025-08-20T02:27:06ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802013-12-0171210.3855/jidc.2854Long term effect of infection control practices and associated factors during a major Clostridium difficile outbreak in Costa RicaRoy A Wong-McClure0Elenita Ramírez-Salas1Nury Mora-Brenes2Lorena Aguero-Sandí3Maritza Morera-Sigler4Xiomara Badilla-Vargas5Marcela Hernández-de Merzerville6Michele O’Shea7Elizabeth Bryce8Epidemiology Office and Surveillance, Caja Costarricense de Seguro Social, Genaro Valverde Building, Second Avenue, San José, Costa RicaEpidemiology Office and Surveillance, Caja Costarricense de Seguro Social, Genaro Valverde Building, Second Avenue, San José, Costa RicaHospital San Juan de Dios, Caja Costarricense de Seguro Social, San José, Costa RicaEpidemiology Office and Surveillance, Caja Costarricense de Seguro Social, Genaro Valverde Building, Second Avenue, San José, Costa RicaEpidemiology Office and Surveillance, Caja Costarricense de Seguro Social, Genaro Valverde Building, Second Avenue, San José, Costa RicaEpidemiology Office and Surveillance, Caja Costarricense de Seguro Social, Genaro Valverde Building, Second Avenue, San José, Costa RicaHospital Nacional de Niños Dr. Carlos Sáenz Herrera, Caja Costarricense de Seguro Social, San José, Costa RicaUniversity of Arizona College of Medicine, Phoenix, Arizona, United StatesVancouver General Hospital, Vancouver, British Columbia, CanadaIntroduction: The C. difficile BI/NAP 1 hyper virulent strain has been responsible for the nosocomial outbreaks in several countries. The present study describes the infection control strategies utilized to achieve outbreak control as well as the factors associated with a C. difficile BI/NAP 1 hyper virulent strain outbreak in Costa Rica. Methodology: A descriptive analysis of the C. difficile outbreak was completed for the period of January 2007 to December 2010 in one affected hospital. An unmatched case-control study was subsequently performed to evaluate the association of exposure factors with C. difficile infection. Results: The pattern of the outbreak was characterized by a sharp increase in the incidence rate during the initial weeks of the outbreak, which was followed by a reduction in the incidence curve as several infection control measures were implemented. The C. difficile BI/NAP1 infection was associated with the prescription of antibiotics, in particular levofloxacin (OR: 9.3; 95%CI: 2.1-40.2), meropenem (OR: 4.9, 95%CI: 1.0-22.9), cefotaxime (OR: 4.3, 95%CI: 2.4-7.7), as well as a medical history of diabetes mellitus (OR: 2.9, 95%CI: 1.5-5.8). Conclusions: The infection control strategies implemented proved to be effective in achieving outbreak control and in maintaining the baseline C. difficile incidence rate following it. The reported C. difficile outbreak was associated with the prescription of broad-spectrum antibiotics and a medical history of diabetes. https://jidc.org/index.php/journal/article/view/2854Clostridium difficileenterocolitisinfection controlinfectious disease outbreaks |
| spellingShingle | Roy A Wong-McClure Elenita Ramírez-Salas Nury Mora-Brenes Lorena Aguero-Sandí Maritza Morera-Sigler Xiomara Badilla-Vargas Marcela Hernández-de Merzerville Michele O’Shea Elizabeth Bryce Long term effect of infection control practices and associated factors during a major Clostridium difficile outbreak in Costa Rica Journal of Infection in Developing Countries Clostridium difficile enterocolitis infection control infectious disease outbreaks |
| title | Long term effect of infection control practices and associated factors during a major Clostridium difficile outbreak in Costa Rica |
| title_full | Long term effect of infection control practices and associated factors during a major Clostridium difficile outbreak in Costa Rica |
| title_fullStr | Long term effect of infection control practices and associated factors during a major Clostridium difficile outbreak in Costa Rica |
| title_full_unstemmed | Long term effect of infection control practices and associated factors during a major Clostridium difficile outbreak in Costa Rica |
| title_short | Long term effect of infection control practices and associated factors during a major Clostridium difficile outbreak in Costa Rica |
| title_sort | long term effect of infection control practices and associated factors during a major clostridium difficile outbreak in costa rica |
| topic | Clostridium difficile enterocolitis infection control infectious disease outbreaks |
| url | https://jidc.org/index.php/journal/article/view/2854 |
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