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Factors Associated with Clostridioides (Clostridium) Difficile Infection and Colonization: Ongoing Prospective Cohort Study in a French University Hospital

Introduction: Clostridioides (Clostridium) difficile can be isolated from stool in 3% of healthy adults and in at least 10% of asymptomatic hospitalized patients. C. difficile, the most common cause of hospital-acquired infectious diarrhea in the developed world, has re-emerged in recent years with...

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Autores principales: Khanafer, Nagham, Vanhems, Philippe, Bennia, Sabrina, Martin-Gaujard, Géraldine, Juillard, Laurent, Rimmelé, Thomas, Argaud, Laurent, Martin, Olivier, Huriaux, Laetitia, Marcotte, Guillaume, Hernu, Romain, Floccard, Bernard, Cassier, Pierre, Group, Study
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8307155/
https://www.ncbi.nlm.nih.gov/pubmed/34299978
http://dx.doi.org/10.3390/ijerph18147528
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author Khanafer, Nagham
Vanhems, Philippe
Bennia, Sabrina
Martin-Gaujard, Géraldine
Juillard, Laurent
Rimmelé, Thomas
Argaud, Laurent
Martin, Olivier
Huriaux, Laetitia
Marcotte, Guillaume
Hernu, Romain
Floccard, Bernard
Cassier, Pierre
Group, Study
author_facet Khanafer, Nagham
Vanhems, Philippe
Bennia, Sabrina
Martin-Gaujard, Géraldine
Juillard, Laurent
Rimmelé, Thomas
Argaud, Laurent
Martin, Olivier
Huriaux, Laetitia
Marcotte, Guillaume
Hernu, Romain
Floccard, Bernard
Cassier, Pierre
Group, Study
author_sort Khanafer, Nagham
collection PubMed
description Introduction: Clostridioides (Clostridium) difficile can be isolated from stool in 3% of healthy adults and in at least 10% of asymptomatic hospitalized patients. C. difficile, the most common cause of hospital-acquired infectious diarrhea in the developed world, has re-emerged in recent years with increasing incidence and severity. In an effort to reduce the spread of the pathogen, published recommendations suggest isolation and contact precautions for patients suffering from C. difficile infection (CDI). However, asymptomatic colonized patients are not targeted by infection control policies, and active surveillance for colonization is not routinely performed. Moreover, given the current changes in the epidemiology of CDI, particularly the emergence of new virulent strains either in the hospital or community settings, there is a need for identification of factors associated with colonization by C. difficile and CDI. Methods and analysis: We are carrying out a prospective, observational, cohort study in Edouard Herriot Hospital, Hospices Civils de Lyon, a 900-bed university hospital in Lyon, France. All consecutive adult patients admitted on selected units are eligible to participate in the study. Stool samples or rectal swabs for C. difficile testing are obtained on admission, every 3–5 days during hospitalization, at the onset of diarrhea (if applicable), and at discharge. Descriptive and logistic regression analyses will be completed to mainly estimate the proportion of asymptomatic colonization at admission, and to evaluate differences between factors associated with colonization and those related to CDI. Ethics: The study is conducted in accordance with the ethical principles of the Declaration of Helsinki, French law, and the Good Clinical Practice guidelines. The study protocol design was approved by the participating units, the ethics committee and the hospital institutional review board (Comité de protection des personnes et Comission Nationale de l’Informatique et des Libertés; N°: 00009118). Dissemination: The results of this study will be disseminated by presenting the findings locally at each participating ward, as well as national and international scientific meetings. Findings will be shared with interested national societies crafting guidelines in CDI.
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spelling pubmed-83071552021-07-25 Factors Associated with Clostridioides (Clostridium) Difficile Infection and Colonization: Ongoing Prospective Cohort Study in a French University Hospital Khanafer, Nagham Vanhems, Philippe Bennia, Sabrina Martin-Gaujard, Géraldine Juillard, Laurent Rimmelé, Thomas Argaud, Laurent Martin, Olivier Huriaux, Laetitia Marcotte, Guillaume Hernu, Romain Floccard, Bernard Cassier, Pierre Group, Study Int J Environ Res Public Health Protocol Introduction: Clostridioides (Clostridium) difficile can be isolated from stool in 3% of healthy adults and in at least 10% of asymptomatic hospitalized patients. C. difficile, the most common cause of hospital-acquired infectious diarrhea in the developed world, has re-emerged in recent years with increasing incidence and severity. In an effort to reduce the spread of the pathogen, published recommendations suggest isolation and contact precautions for patients suffering from C. difficile infection (CDI). However, asymptomatic colonized patients are not targeted by infection control policies, and active surveillance for colonization is not routinely performed. Moreover, given the current changes in the epidemiology of CDI, particularly the emergence of new virulent strains either in the hospital or community settings, there is a need for identification of factors associated with colonization by C. difficile and CDI. Methods and analysis: We are carrying out a prospective, observational, cohort study in Edouard Herriot Hospital, Hospices Civils de Lyon, a 900-bed university hospital in Lyon, France. All consecutive adult patients admitted on selected units are eligible to participate in the study. Stool samples or rectal swabs for C. difficile testing are obtained on admission, every 3–5 days during hospitalization, at the onset of diarrhea (if applicable), and at discharge. Descriptive and logistic regression analyses will be completed to mainly estimate the proportion of asymptomatic colonization at admission, and to evaluate differences between factors associated with colonization and those related to CDI. Ethics: The study is conducted in accordance with the ethical principles of the Declaration of Helsinki, French law, and the Good Clinical Practice guidelines. The study protocol design was approved by the participating units, the ethics committee and the hospital institutional review board (Comité de protection des personnes et Comission Nationale de l’Informatique et des Libertés; N°: 00009118). Dissemination: The results of this study will be disseminated by presenting the findings locally at each participating ward, as well as national and international scientific meetings. Findings will be shared with interested national societies crafting guidelines in CDI. MDPI 2021-07-15 /pmc/articles/PMC8307155/ /pubmed/34299978 http://dx.doi.org/10.3390/ijerph18147528 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Protocol
Khanafer, Nagham
Vanhems, Philippe
Bennia, Sabrina
Martin-Gaujard, Géraldine
Juillard, Laurent
Rimmelé, Thomas
Argaud, Laurent
Martin, Olivier
Huriaux, Laetitia
Marcotte, Guillaume
Hernu, Romain
Floccard, Bernard
Cassier, Pierre
Group, Study
Factors Associated with Clostridioides (Clostridium) Difficile Infection and Colonization: Ongoing Prospective Cohort Study in a French University Hospital
title Factors Associated with Clostridioides (Clostridium) Difficile Infection and Colonization: Ongoing Prospective Cohort Study in a French University Hospital
title_full Factors Associated with Clostridioides (Clostridium) Difficile Infection and Colonization: Ongoing Prospective Cohort Study in a French University Hospital
title_fullStr Factors Associated with Clostridioides (Clostridium) Difficile Infection and Colonization: Ongoing Prospective Cohort Study in a French University Hospital
title_full_unstemmed Factors Associated with Clostridioides (Clostridium) Difficile Infection and Colonization: Ongoing Prospective Cohort Study in a French University Hospital
title_short Factors Associated with Clostridioides (Clostridium) Difficile Infection and Colonization: Ongoing Prospective Cohort Study in a French University Hospital
title_sort factors associated with clostridioides (clostridium) difficile infection and colonization: ongoing prospective cohort study in a french university hospital
topic Protocol
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8307155/
https://www.ncbi.nlm.nih.gov/pubmed/34299978
http://dx.doi.org/10.3390/ijerph18147528
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