clostridiumdifficile infection in surgery 1257 In conclusion, we found a variable incidence of CDI among
surgical specialties at a single tertiary-care hospital. Our ana- lysis suggests that higher ASA class, pre- or postoperative antibiotic use (outside of the perioperative period), and more admissions in the past year are associated with increased odds of CDI. Future studies should examine antibiotic stewardship efforts in the surgical population for reducing CDI.
acknowledgments
Financial support. None reported. Conflicts of interest. All authors report no conflicts of interest relevant to this
article. Affiliations: 1. Department of Orthopedics and Rehabilitative Medicine;
University of Wisconsin School of Medicine & Public Health, Madison, Wisconsin; 2. Department of Medicine, Division of Infectious Disease, University of Wisconsin School of Medicine & Public Health, Madison, Wisconsin; 3. William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin; 4. Department of Biostatistics and Medical Informatics, University ofWisconsin–Madison, Madison, Wisconsin. Address correspondence to James Bernatz, MD, UW Medical Foundation Centennial Buildingm 1685 Highland Avenue, 6th Floor, Madison, WI 53705- 2281 (
jbernatz@wisc.edu).
Received April 4, 2017; accepted June 25, 2017; electronically published July
31, 2017 © 2017 by The Society for Healthcare Epidemiology of America. All rights reserved. 0899-823X/2017/3810-0019. DOI: 10.1017/ice.2017.158
references
1. Maltenfort MG, Rasouli MR, Morrison TA, Parvizi J. Clostridium difficile colitis in patients undergoing lower-extremity
arthroplasty: rare infection with major impact. Clin Orthop Relat Res 2013;471:3178–3185.
2. Sharma P, Bomireddy R, Phillips S. Clostridium difficile-asso- ciated diarrhoea after internal fixation of intertrochanteric femoral fractures. Eur J Clin Microbiol Infect Dis 2003;22: 615–618.
3. Damle RN, Cherng NB, Flahive JM, et al. Clostridium difficile infection after colorectal surgery: a rare but costly complication. J Gastrointest Surg 2014;18:1804–1811.
4. Dasenbrock HH, Bartolozzi AR, Gormley WB, Frerichs KU, Aziz-Sultan MA, Du R. Clostridium difficile infection after subarachnoid hemorrhage: a nationwide analysis. Neurosurgery 2016;78:412–420.
5. Egorova NN, Siracuse JJ, McKinsey JF, Nowygrod R. Trend, risk factors, and costs of Clostridium difficile infections in vascular surgery. Ann Vasc Surg 2015;29:792–800.
6. Guzman JZ, Skovrlj B, Rothenberg ES, et al. The burden of Clostridium difficile after cervical spine surgery. Global Spine J 2016;6:314–321.
7. Krapohl GL, Morris AM, Cai S, et al. Preoperative risk factors for postoperative Clostridium difficile infection in colectomy patients. Am J Surg 2013;205:343–347; discussion 347–348.
8. Shah K, Pass LA, Cox M, Lanham M, Arnold FW. Evaluating contemporary antibiotics as a risk factor for Clostridium difficile infection in surgical trauma patients. J Trauma Acute Care Surg 2012;72:691–695.
9. Zacharioudakis IM, Zervou FN, Pliakos EE, Ziakas PD, Mylonakis E. Colonization with toxinogenic C. difficile upon hospital admission, and risk of infection: a systematic review and meta-analysis. Am J Gastroenterol 2015;110:381–390; quiz 391.
10. Lewallen S, Courtright P. Epidemiology in practice: case-control studies. Community Eye Health 1998;11:57–58.
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80 |
Page 81 |
Page 82 |
Page 83 |
Page 84 |
Page 85 |
Page 86 |
Page 87 |
Page 88 |
Page 89 |
Page 90 |
Page 91 |
Page 92 |
Page 93 |
Page 94 |
Page 95 |
Page 96 |
Page 97 |
Page 98 |
Page 99 |
Page 100 |
Page 101 |
Page 102 |
Page 103 |
Page 104 |
Page 105 |
Page 106 |
Page 107 |
Page 108 |
Page 109 |
Page 110 |
Page 111 |
Page 112 |
Page 113 |
Page 114 |
Page 115 |
Page 116 |
Page 117 |
Page 118 |
Page 119 |
Page 120 |
Page 121 |
Page 122 |
Page 123 |
Page 124 |
Page 125 |
Page 126 |
Page 127 |
Page 128 |
Page 129 |
Page 130 |
Page 131 |
Page 132 |
Page 133 |
Page 134 |
Page 135 |
Page 136 |
Page 137 |
Page 138 |
Page 139 |
Page 140 |
Page 141 |
Page 142 |
Page 143 |
Page 144
