{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T16:25:04Z","timestamp":1759335904223},"reference-count":28,"publisher":"Cambridge University Press (CUP)","issue":"11","license":[{"start":{"date-parts":[[2015,1,2]],"date-time":"2015-01-02T00:00:00Z","timestamp":1420156800000},"content-version":"unspecified","delay-in-days":4445,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2002,11]]},"abstract":"<jats:sec id=\"S0195941700078723_abs1\"><jats:title>Objective:<\/jats:title><jats:p>To compare the occurrence of<jats:italic>Clostridium difficile<\/jats:italic>among inpatients infected with human immunodeficiency virus (HPV) in two different hospitals.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700078723_abs2\"><jats:title>Design:<\/jats:title><jats:p>Prospective, observational study.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700078723_abs3\"><jats:title>Setting:<\/jats:title><jats:p>Specialized HPV inpatient units.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700078723_abs4\"><jats:title>Patients:<\/jats:title><jats:p>HIV-infected inpatients at Cook County Hospital (CCH) and Rush Presbyterian St. Luke's Medical Center (RPSLMC).<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700078723_abs5\"><jats:title>Interventions:<\/jats:title><jats:p>A clinical and epidemiologic assessment of patient risk factors for<jats:italic>C. difficile<\/jats:italic>was performed.<jats:italic>C. difficile<\/jats:italic>isolates found on stool, rectal, and environmental cultures were typed by pulsed-field gel electrophoresis.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700078723_abs6\"><jats:title>Results:<\/jats:title><jats:p>Twenty-seven percent of patients admitted to CCH versus 4% of patients admitted to RPSLMC had positive cultures for<jats:italic>C. difficile<\/jats:italic>(<jats:italic>P<\/jats:italic>= .001). At CCH, 14.7% of environmental cultures were positive versus 2.9% at RPSLMC (<jats:italic>P<\/jats:italic>= .002). Risk factors for<jats:italic>C. difficile<\/jats:italic>acquisition included hospitalization at CCH, more severe HrV, use of acyclovir and H<jats:sub>2<\/jats:sub>-blockers, and longer hospital stay. Patients admitted to CCH were taking more antibiotics, had longer hospital stays, and more frequently had a history of<jats:italic>C. difficile<\/jats:italic>infection. During the study, two strains (CD1A and CD4) extensively contaminated the CCH environment. However, only CD1A caused an outbreak.<\/jats:p><\/jats:sec><jats:sec id=\"S0195941700078723_abs7\"><jats:title>Conclusions:<\/jats:title><jats:p>The<jats:italic>C. difficile<\/jats:italic>acquisition rate at CCH was sevenfold higher than that at RPSLMC, and CCH had a more contaminated environment Differences in patient acquisition rates likely reflect a greater prevalence of traditional<jats:italic>C. difficile<\/jats:italic>risk factors and a concurrent outbreak at CCH. Although two strains heavily contaminated the environment at CCH, only one caused an outbreak, suggesting that factors other than the environment are important in initiating<jats:italic>C. difficile<\/jats:italic>outbreak.<\/jats:p><\/jats:sec>","DOI":"10.1086\/501987","type":"journal-article","created":{"date-parts":[[2006,2,21]],"date-time":"2006-02-21T15:46:05Z","timestamp":1140536765000},"page":"641-647","source":"Crossref","is-referenced-by-count":18,"title":["Difference in the Incidence of<i>Clostridium difficile<\/i>Among Patients Infected With Human Immunodeficiency Virus Admitted to a Public Hospital and a Private Hospital"],"prefix":"10.1017","volume":"23","author":[{"given":"Joseph J.","family":"Pulvirenti","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dale N.","family":"Gerding","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catherine","family":"Nathan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irfan","family":"Hafiz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tarun","family":"Mehra","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dayle","family":"Marsh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frank","family":"Kocka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Rice","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Staci A.","family":"Fischer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Segreti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert A.","family":"Weinstein","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2015,1,2]]},"reference":[{"key":"S0195941700078723_ref010","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(95)92649-6"},{"key":"S0195941700078723_ref002","first-page":"64","article-title":"CDAD rates: reply","volume":"16","author":"Olson","year":"1995","journal-title":"Infect Control Hosp Epidemiol"},{"key":"S0195941700078723_ref025","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/18.2.181"},{"key":"S0195941700078723_ref022","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198901263200402"},{"key":"S0195941700078723_ref014","unstructured":"Pulvirenti J , Mehra T , Hafiz I , et al. 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