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Investigation of a cluster of Clostridium difficile infections in a pediatric oncology setting.
- Source :
-
American journal of infection control [Am J Infect Control] 2016 Feb; Vol. 44 (2), pp. 138-45. Date of Electronic Publication: 2015 Oct 23. - Publication Year :
- 2016
-
Abstract
- Background: We investigated an increase in Clostridium difficile infection (CDI) among pediatric oncology patients.<br />Methods: CDI cases were defined as first C difficile positive stool tests between December 1, 2010, and September 6, 2012, in pediatric oncology patients receiving inpatient or outpatient care at a single hospital. A case-control study was performed to identify CDI risk factors, infection prevention and antimicrobial prescribing practices were assessed, and environmental sampling was conducted. Available isolates were strain-typed by pulsed-field gel electrophoresis.<br />Results: An increase in hospital-onset CDI cases was observed from June-August 2012. Independent risk factors for CDI included hospitalization in the bone marrow transplant ward and exposure to computerized tomography scanning or cefepime in the prior 12 weeks. Cefepime use increased beginning in late 2011, reflecting a practice change for patients with neutropenic fever. There were 13 distinct strain types among 22 available isolates. Hospital-onset CDI rates decreased to near-baseline levels with enhanced infection prevention measures, including environmental cleaning and prolonged contact isolation.<br />Conclusion: C difficile strain diversity associated with a cluster of CDI among pediatric oncology patients suggests a need for greater understanding of modes and sources of transmission and strategies to reduce patient susceptibility to CDI. Further research is needed on the risk of CDI with cefepime and its use as primary empirical treatment for neutropenic fever.<br /> (Published by Elsevier Inc.)
- Subjects :
- Adolescent
Case-Control Studies
Cefepime
Child
Child, Preschool
Clostridioides difficile classification
Clostridioides difficile drug effects
Clostridium Infections drug therapy
Clostridium Infections microbiology
Cross Infection drug therapy
Cross Infection microbiology
Feces microbiology
Female
Hospitalization
Hospitals
Humans
Infant
Male
Medical Oncology
Pediatrics
Risk Factors
Young Adult
Anti-Bacterial Agents therapeutic use
Cephalosporins therapeutic use
Clostridioides difficile isolation & purification
Clostridium Infections epidemiology
Cross Infection epidemiology
Infection Control
Subjects
Details
- Language :
- English
- ISSN :
- 1527-3296
- Volume :
- 44
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- American journal of infection control
- Publication Type :
- Academic Journal
- Accession number :
- 26601705
- Full Text :
- https://doi.org/10.1016/j.ajic.2015.09.004