Background: Hospital Onset Clostridium difficile infection (HOCDI) is one of the most common causes of hospital acquired diarrhea. As per a recent study, the mean healthcare costs attributable to primary Clostridium difficile infection (CDI) is about $24,205 per patient. This would be a lot more if the patients were to be discharged to skilled nursing [...]

Background: Stony Brook University Hospital (SBUH) identified an opportunity to develop and implement prevention strategies to reduce hospital onset C. difficile infections (CDI). Hospital Onset (HO) CDI are included in National Healthcare Safety Network (NHSN) reporting and included with other hospital-acquired infections as publically reported data. CDI contribute to prolonged hospital stays, inappropriate antimicrobial use, [...]

Background: Though the advent of highly active anti-retroviral medications has improved survival in HIV infection, mortality from non-infectious complications such as pulmonary arterial hypertension (PAH) has increased. Also, studies have shown that PAH is the leading cause of hospitalization and death in patients with HIV associated PAH (HIV-PAH). However, not much is known about the [...]

Background: Patients hospitalized with hematologic malignancy are particularly vulnerable to infection. Clostridium difficile infection (CDI) has become the most common cause of healthcare-associated infections in U. S. hospitals, and the excess healthcare costs related to CDI are estimated to be as much as 4. 8 billion dollars for acute care facilities alone. We sought to [...]

Background: Data is emerging on the efficacy of fecal microbial transplantation (FMT) for recurrent clostridium difficile infection (CDI) management with success rates of 80-90% in general population. Immunocompromised patients continue to be excluded from randomized trials involving FMT due to concerns related to its safety and efficacy. Current guidelines recommend caution with FMT in immunocompromised [...]

Background: Rifaximin 550 mg tablets is a nonsystemic antibiotic indicated for reducing the risk of overt hepatic encephalopathy (OHE) recurrence in adults and may be used alone or in combination with the cathartic lactulose. This analysis evaluated the safety profile of rifaximin alone vs rifaximin + lactulose (combination) in patients with cirrhosis. Methods: In a [...]

Background: Guidelines on the treatment of Clostridioides (Clostridium) difficile infection (CDI) have historically recommended avoiding antimotility agents (AAs) in patients with active CDI based on theoretical concerns that administration of AAs may precipitate serious adverse events such as toxic megacolon in these patients. These recommendations, however, are based on limited and conflicting data. We previously [...]

Background: Clostridioides difficile infection (CDI) can be prevented through infection prevention practices and antibiotic stewardship. We found in a 2013 national survey (571 hospitals, 71% response rate) that while infection prevention practices for CDI were common in U.S. hospitals, only 52% had an antibiotic stewardship program (ASP). On 1 January 2017, The Joint Commission required [...]

Background: There are 400,000 cases and 30,000 deaths from Clostridium difficile (C. diff) infections in the United States annually. Efforts to reduce the transmission of C. diff have focused on patients with diarrhea, however, many patients with C. diff are carriers who do not have symptoms. Because they are not isolated, carriers serve as a [...]

Background: Timely Clostridium difficile Infection (CDI) testing is challenging but is important for faster and appropriate isolation and treatment of patients. Few studies have specifically addressed effective methods to hasten CDI testing without relying on PCR. We sought to use Quality Improvement methodologies including the Plan-Do-Study-Act (PDSA) Cycle and Control Charts to reduce CDI testing [...]