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Underdiagnosis of C...
Underdiagnosis of Clostridium difficile across Europe : the European, multicentre, prospective, biannual, point-prevalence study of Clostridium difficile infection in hospitalised patients with diarrhoea (EUCLID)
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- Davies, Kerrie A. (författare)
- EUCLID European Coordinators, Univ Leeds, Leeds, England
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- Longshaw, Christopher M. (författare)
- Astellas Pharma Europe, Chertsey, England
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- Davis, Georgina L. (författare)
- EUCLID European Coordinators, Univ Leeds, Leeds, England
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- Bouza, Emilio (författare)
- Microbiol Clin E Infecc, Catedral Jefe Serv, Gen Hosp, Univ Gregorio Maranon, Madrid, Spain
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- Barbut, Frederic (författare)
- Natl Reference Lab Clostridium Difficile, Univ Paris 06, Paris, France
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- Barna, Zsuzsanna (författare)
- Dept Bacteriol, Natl Ctr Epidemiol, Budapest, Hungary
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- Delmee, Michel (författare)
- Institute of Experimental and Clinical Research, Catholic Univ Louvain, Brussels, Belgium
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- Fitzpatrick, Fidelma (författare)
- Hlth Protect Surveillance Ctr, Dublin, Ireland; Beaumont Hosp, Dublin, Ireland
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- Ivanova, Kate (författare)
- Natl Ctr Infect & Parasit Dis, Sofia, Bulgaria
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- Kuijper, Ed (författare)
- Med Ctr, Dept Med Microbiol, Leiden Univ, Leiden, Netherlands
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- Macovei, Ioana S. (författare)
- Cantacuzino Natl Inst Res & Dev Microbiol & Immun, Bucharest, Romania
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- Mentula, Silja (författare)
- Bacteriol Unit, Natl Inst Hlth & Welf (THL), Helsinki, Finland
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- Mastrantonio, Paola (författare)
- Dept Infect Dis, Ist Super Sanita, Rome, Italy
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- von Mueller, Lutz (författare)
- Med Ctr, Inst Med Microbiol & Hyg, Univ Saarland, Homburg, Germany
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- Oleastro, Monica (författare)
- Dept Infect Dis, Natl Inst Hlth Dr Ricardo Jorge, Lisbon, Portugal
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- Petinaki, Efthymia (författare)
- Sch Med, Univ Hosp, Univ Thessalia, Larisa, Greece
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- Pituch, Hanna (författare)
- Dept Med Microbiol, Med Univ Warsaw, Warsaw, Poland
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- Norén, Torbjörn, 1955- (författare)
- Region Örebro län
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- Novakova, Elena (författare)
- Jessenius Fac Med Martin, Comenius Univ, Martin, Slovakia
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- Nyc, Otakar (författare)
- Dept Med Microbiol, Univ Hosp Motol, Prague, Czech Republic
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- Rupnik, Maja (författare)
- Fac Med, Univ Maribor, Maribor, Slovenia; Natl Lab Hlth Environm & Food (NLZOH), Maribor, Slovenia
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- Schmid, Daniela (författare)
- Inst Med Microbiol & Hyg, Austrian Agcy Hlth & Food Safety, Vienna,Austria.
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- Wilcox, Mark H. (författare)
- EUCLID European Coordinators, Univ Leeds, Leeds, England
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(creator_code:org_t)
- Elsevier, 2014
- 2014
- Engelska.
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Ingår i: The Lancet - Infectious diseases. - : Elsevier. - 1473-3099 .- 1474-4457. ; 14:12, s. 1208-1219
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
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- Background: Variations in testing for Clostridium difficile infection can hinder patients' care, increase the risk of transmission, and skew epidemiological data. We aimed to measure the underdiagnosis of C difficile infection across Europe.Methods: We did a questionnaire-based study at 482 participating hospitals across 20 European countries. Hospitals were questioned about their methods and testing policy for C difficile infection during the periods September, 2011, to August, 2012, and September, 2012, to August, 2013. On one day in winter, 2012-13 (December, 2012, or January, 2013), and summer, 2013 (July or August), every hospital sent all diarrhoeal samples submitted to their microbiology laboratory to a national coordinating laboratory for standardised testing of C difficile infection. Our primary outcome measures were the rates of testing for and cases of C difficile infection per 10 000 patient bed-days. Results of local and national C difficile infection testing were compared with each other. If the result was positive at the national laboratory but negative at the local hospital, the result was classified as undiagnosed C difficile infection. We compared differences in proportions with the Mann-Whitney test, or McNemar's test if data were matched.Findings: During the study period, participating hospitals reported a mean of 65.8 tests (country range 4. 6-223.3) for C difficile infection per 10 000 patient-bed days and a mean of 7.0 cases (country range 0.7-28.7) of C difficile infection per 10 000 patient-bed days. Only two-fifths of hospitals reported using optimum methods for testing of C difficile infection (defined by European guidelines), although the number of participating hospitals using optimum methods increased during the study period, from 152 (32%) of 468 in 2011-12 to 205 (48%) of 428 in 2012-13. Across all 482 European hospitals on the two sampling days, 148 (23%) of 641 samples positive for C difficile infection (as determined by the national laboratory) were not diagnosed by participating hospitals because of an absence of clinical suspicion, equating to about 74 missed diagnoses per day.Interpretation: A wide variety of testing strategies for C difficile infection are used across Europe. Absence of clinical suspicion and suboptimum laboratory diagnostic methods mean that an estimated 40 000 inpatients with C difficile infection are potentially undiagnosed every year in 482 European hospitals.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Infektionsmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Infectious Medicine (hsv//eng)
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Davies, Kerrie A ...
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Longshaw, Christ ...
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Davis, Georgina ...
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Bouza, Emilio
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Barbut, Frederic
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Barna, Zsuzsanna
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visa fler...
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Delmee, Michel
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Fitzpatrick, Fid ...
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Ivanova, Kate
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Kuijper, Ed
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Macovei, Ioana S ...
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Mentula, Silja
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Mastrantonio, Pa ...
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von Mueller, Lut ...
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Oleastro, Monica
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Petinaki, Efthym ...
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Pituch, Hanna
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Norén, Torbjörn, ...
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Novakova, Elena
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Nyc, Otakar
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Rupnik, Maja
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Schmid, Daniela
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Wilcox, Mark H.
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