TY - JOUR
TI - Association between consumption of antibiotics, infection control interventions and Clostridioides difficile infections: Analysis of six-year time-series data in a tertiary-care hospital in Greece
AU - Papanikolopoulou, A.
AU - Maltezou, H.C.
AU - Gargalianos-Kakolyris, P.
AU - Pangalis, A.
AU - Pantazis, N.
AU - Pantos, C.
AU - Tountas, Y.
AU - Tsakris, A.
AU - Kantzanou, M.
JO - Infection, Disease and Health
PY - 2022
VL - null
TODO - null
SP - null
PB - Australasian College for Infection Prevention and Control
SN - null
TODO - 10.1016/j.idh.2022.01.002
TODO - null
TODO - Background: To investigate the association between Clostridioides difficile infection (CDI), antibiotic use, and infection control interventions, during an antibiotic stewardship program (ASP) implemented in a tertiary-care hospital in Greece from 2013 to 2018. Methods: Analysis was applied for the following monthly indices: 1. consumption of antibiotics; 2. use of hand hygiene disinfectant solutions; 3. percentage of isolations of patients either with multidrug-resistant (MDR) bacteria, or CDI, or admitted from another hospital; and 4. percentage of patients with CDI divided into two groups: community-acquired CDI (CACDI) and hospital-associated CDI (HACDI) (onset ≤72 h and >72 h after admission, respectively). Results: During the study, a significant reduction in CACDI rate from 0.3%/admissions [95% CI 0.1–0.6] to 0.1%/admissions [95% CI 0.0–0.3] (p-value = 0.035) was observed in adults ICU, while CDI rates were stable in the rest of the hospital. Antibiotic consumption showed a significant reduction in total hospital, from 91.7 DDDs [95% CI 89.7–93.7] to 80.1 DDDs [95% CI 79.1–81.1] (p-value<0.001), except adults ICU. Non-advanced antibiotics correlated with decreased CDI rates in Adults Clinic Departments and ICU. Isolation of patients one and two months earlier correlated with decreased CACDI rates per 20% [95% CI 0.64–1.00, p-value = 0.046] and HACDI per 23% [95% CI 0.60–1.00, p-value = 0.050] in Adults Clinic Departments. Consumption of disinfectant solutions current month correlated with decreased rate for CACDI per 33% [95% CI 0.49–0.91, p-value = 0.011] and HACDI per 38% [95% CI 0.40–0.98, p-value = 0.040] in total Hospital Clinics. Conclusion: Rational antibiotic prescribing during ASP along with multipronged intervention strategy focusing on hand hygiene and patient isolation measures prevent and control CDI outbreaks in the hospital setting. © 2022 Australasian College for Infection Prevention and Control
ER -