Abstract
Objectives: Clostridium difficile is a leading cause of hospital-associated infection in the United States. The purpose of this study is to assess the prevalence of C. difficile infection among mechanically ventilated patients within the ICUs of three academic hospitals and secondarily describe the influence of C. difficile infection on the outcomes of these patients. Design: A retrospective cohort study. Setting: ICUs at three teaching hospitals: Barnes-Jewish Hospital, Mayo Clinic, and Creighton University Medical Center over a 2-year period. Patients: All hospitalized patients requiring mechanical ventilation for greater than 48 hours within an ICU were eligible for inclusion. Interventions: None. Measurements and Main Results: A total of 5,852 consecutive patients admitted to the ICU were included. Three hundred eighty-six (6.6%) patients with development of C. difficile infection while in the hospital (5.39 cases/1,000 patient days). Septic shock complicating C. difficile infection occurred in 34.7% of patients. Compared with patients without C. difficile infection (n = 5,466), patients with C. difficile infection had a similar hospital mortality rate (25.1% vs 26.3%, p = 0.638). Patients with C. difficile infection were significantly more likely to be discharged to a skilled nursing or rehabilitation facility (42.4% vs 31.9%, p <0.001), and the median hospital (23 d vs 15 d, p <0.001) and ICU length of stay (12 d vs 8 d, p <0.001) were found to be significantly longer in patients with C. difficile infection. Conclusions: Clostridium difficile infection is a relatively common nosocomial infection in mechanically ventilated patients and is associated with prolonged length of hospital and ICU stay, and increased need for skilled nursing care or rehabilitation following hospital discharge.
| Original language | English |
|---|---|
| Pages (from-to) | 1968-1975 |
| Number of pages | 8 |
| Journal | Critical Care Medicine |
| Volume | 41 |
| Issue number | 8 |
| DOIs | |
| State | Published - Aug 2013 |
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All Science Journal Classification (ASJC) codes
- Critical Care and Intensive Care Medicine
Cite this
Clostridium difficile infection : A multicenter study of epidemiology and outcomes in mechanically ventilated patients. / Micek, Scott T.; Schramm, Garrett; Morrow, Lee E.; Frazee, Erin; Personett, Heather; Doherty, Joshua A.; Hampton, Nicholas; Hoban, Alex; Lieu, Angela; McKenzie, Matthew; Dubberke, Erik R.; Kollef, Marin H.
In: Critical Care Medicine, Vol. 41, No. 8, 08.2013, p. 1968-1975.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Clostridium difficile infection
T2 - A multicenter study of epidemiology and outcomes in mechanically ventilated patients
AU - Micek, Scott T.
AU - Schramm, Garrett
AU - Morrow, Lee E.
AU - Frazee, Erin
AU - Personett, Heather
AU - Doherty, Joshua A.
AU - Hampton, Nicholas
AU - Hoban, Alex
AU - Lieu, Angela
AU - McKenzie, Matthew
AU - Dubberke, Erik R.
AU - Kollef, Marin H.
PY - 2013/8
Y1 - 2013/8
N2 - Objectives: Clostridium difficile is a leading cause of hospital-associated infection in the United States. The purpose of this study is to assess the prevalence of C. difficile infection among mechanically ventilated patients within the ICUs of three academic hospitals and secondarily describe the influence of C. difficile infection on the outcomes of these patients. Design: A retrospective cohort study. Setting: ICUs at three teaching hospitals: Barnes-Jewish Hospital, Mayo Clinic, and Creighton University Medical Center over a 2-year period. Patients: All hospitalized patients requiring mechanical ventilation for greater than 48 hours within an ICU were eligible for inclusion. Interventions: None. Measurements and Main Results: A total of 5,852 consecutive patients admitted to the ICU were included. Three hundred eighty-six (6.6%) patients with development of C. difficile infection while in the hospital (5.39 cases/1,000 patient days). Septic shock complicating C. difficile infection occurred in 34.7% of patients. Compared with patients without C. difficile infection (n = 5,466), patients with C. difficile infection had a similar hospital mortality rate (25.1% vs 26.3%, p = 0.638). Patients with C. difficile infection were significantly more likely to be discharged to a skilled nursing or rehabilitation facility (42.4% vs 31.9%, p <0.001), and the median hospital (23 d vs 15 d, p <0.001) and ICU length of stay (12 d vs 8 d, p <0.001) were found to be significantly longer in patients with C. difficile infection. Conclusions: Clostridium difficile infection is a relatively common nosocomial infection in mechanically ventilated patients and is associated with prolonged length of hospital and ICU stay, and increased need for skilled nursing care or rehabilitation following hospital discharge.
AB - Objectives: Clostridium difficile is a leading cause of hospital-associated infection in the United States. The purpose of this study is to assess the prevalence of C. difficile infection among mechanically ventilated patients within the ICUs of three academic hospitals and secondarily describe the influence of C. difficile infection on the outcomes of these patients. Design: A retrospective cohort study. Setting: ICUs at three teaching hospitals: Barnes-Jewish Hospital, Mayo Clinic, and Creighton University Medical Center over a 2-year period. Patients: All hospitalized patients requiring mechanical ventilation for greater than 48 hours within an ICU were eligible for inclusion. Interventions: None. Measurements and Main Results: A total of 5,852 consecutive patients admitted to the ICU were included. Three hundred eighty-six (6.6%) patients with development of C. difficile infection while in the hospital (5.39 cases/1,000 patient days). Septic shock complicating C. difficile infection occurred in 34.7% of patients. Compared with patients without C. difficile infection (n = 5,466), patients with C. difficile infection had a similar hospital mortality rate (25.1% vs 26.3%, p = 0.638). Patients with C. difficile infection were significantly more likely to be discharged to a skilled nursing or rehabilitation facility (42.4% vs 31.9%, p <0.001), and the median hospital (23 d vs 15 d, p <0.001) and ICU length of stay (12 d vs 8 d, p <0.001) were found to be significantly longer in patients with C. difficile infection. Conclusions: Clostridium difficile infection is a relatively common nosocomial infection in mechanically ventilated patients and is associated with prolonged length of hospital and ICU stay, and increased need for skilled nursing care or rehabilitation following hospital discharge.
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UR - http://www.scopus.com/inward/citedby.url?scp=84880954673&partnerID=8YFLogxK
U2 - 10.1097/CCM.0b013e31828a40d5
DO - 10.1097/CCM.0b013e31828a40d5
M3 - Article
C2 - 23863229
AN - SCOPUS:84880954673
VL - 41
SP - 1968
EP - 1975
JO - Critical Care Medicine
JF - Critical Care Medicine
SN - 0090-3493
IS - 8
ER -