{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T21:47:27Z","timestamp":1747172847009,"version":"3.40.5"},"reference-count":16,"publisher":"Cambridge University Press (CUP)","issue":"5","license":[{"start":{"date-parts":[[2020,11,25]],"date-time":"2020-11-25T00:00:00Z","timestamp":1606262400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0899823X20012374_as1\"><jats:title>Objectives:<\/jats:title><jats:p>To assess Connecticut medical providers\u2019 concordance (2018\u20132019) with the 2017 <jats:italic>Clostridioides difficile<\/jats:italic> infection (CDI) treatment update by the Infectious Disease Society of America (IDSA) and the Society for Healthcare Epidemiology of America (SHEA). The effect of guideline concordance on CDI recurrence risk was also assessed.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X20012374_as2\"><jats:title>Design:<\/jats:title><jats:p>Prospective, population-based study.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X20012374_as3\"><jats:title>Setting:<\/jats:title><jats:p>New Haven County, Connecticut, from January 1, 2017, to December 31, 2019.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X20012374_as4\"><jats:title>Patients:<\/jats:title><jats:p>CDI incident case (no positive tests in the prior 8 weeks), not limited by care setting.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X20012374_as5\"><jats:title>Methods:<\/jats:title><jats:p>Using data from the Emerging Infections Program\u2019s CDI surveillance, severity and concordance were defined. Presence of megacolon and\/or ileus defined fulminant disease; absence defined nonsevere\/severe disease. Using 2017 treatment as baseline, 2018\u20132019 concordance was defined as receiving the recommended first-line antibiotic (ie, vancomycin or fidaxomicin for adult patients, vancomycin or metronidazole for pediatric patients) for exactly 10 days. For all analyses, significance was <jats:italic>P<\/jats:italic> &lt; .05.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X20012374_as6\"><jats:title>Results:<\/jats:title><jats:p>Among 990 cases, concordance increased from 24.8% in 2018 to 37.0% in 2019. First-line antibiotic concordance increased from 61.2% in 2018 to 79.9% in 2019. Recurrence risk was significantly associated with patients aged \u226565 years and was highest for those aged 75\u201384 years, but this factor was not significantly associated with concordance.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X20012374_as7\"><jats:title>Conclusions:<\/jats:title><jats:p>From 2018 through 2019, CDI treatment in New Haven County increasingly was concordant with the 2017 treatment update but remained low in 2019. Although concordance with treatment guidelines did not affect recurrence risk, close attention should be paid by medical providers to patients aged \u226565 years, specifically those aged 75\u201384 years because they are at an increased risk for recurrence.<\/jats:p><\/jats:sec>","DOI":"10.1017\/ice.2020.1237","type":"journal-article","created":{"date-parts":[[2020,11,25]],"date-time":"2020-11-25T06:25:50Z","timestamp":1606285550000},"page":"549-556","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":1,"title":["Evaluation of Connecticut medical providers\u2019\u00a0concordance with 2017 IDSA\/SHEA <i>Clostridioides difficile<\/i> treatment guidelines in New Haven County, 2018\u20132019"],"prefix":"10.1017","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3669-9821","authenticated-orcid":false,"given":"Casey Morgan","family":"Luc","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danyel","family":"Olson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David B.","family":"Banach","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paula","family":"Clogher","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Hadler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2020,11,25]]},"reference":[{"key":"S0899823X20012374_ref15","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis462"},{"key":"S0899823X20012374_ref4","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciu313"},{"key":"S0899823X20012374_ref7","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofz360.1667"},{"key":"S0899823X20012374_ref14","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2016.9045"},{"key":"S0899823X20012374_ref2","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2011.398"},{"key":"S0899823X20012374_ref8","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofz360.847"},{"key":"S0899823X20012374_ref11","doi-asserted-by":"publisher","DOI":"10.5217\/ir.2014.12.4.299"},{"key":"S0899823X20012374_ref13","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofx078"},{"key":"S0899823X20012374_ref9","first-page":"481","article-title":"Evaluation of adherence to treatment guidelines among cases of Clostridium difficile infection in New Haven County, Connecticut, 2013\u20132016","volume":"8","author":"Martinez","year":"2018","journal-title":"Connecticut Med"},{"key":"S0899823X20012374_ref16","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(17)30751-X"},{"key":"S0899823X20012374_ref1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1306801"},{"key":"S0899823X20012374_ref3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1910215"},{"key":"S0899823X20012374_ref12","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa484"},{"key":"S0899823X20012374_ref10","doi-asserted-by":"publisher","DOI":"10.1086\/430311"},{"key":"S0899823X20012374_ref6","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cix1085"},{"key":"S0899823X20012374_ref5","doi-asserted-by":"publisher","DOI":"10.1097\/MOG.0000000000000489"}],"container-title":["Infection Control &amp; Hospital Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0899823X20012374","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,2,18]],"date-time":"2022-02-18T10:47:52Z","timestamp":1645181272000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0899823X20012374\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11,25]]},"references-count":16,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2021,5]]}},"alternative-id":["S0899823X20012374"],"URL":"https:\/\/doi.org\/10.1017\/ice.2020.1237","relation":{},"ISSN":["0899-823X","1559-6834"],"issn-type":[{"type":"print","value":"0899-823X"},{"type":"electronic","value":"1559-6834"}],"subject":[],"published":{"date-parts":[[2020,11,25]]},"assertion":[{"value":"\u00a9 2020 by The Society for Healthcare Epidemiology of America. All rights reserved.","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}