Publication: Cost and length of hospital stay for healthcare facility-onset clostridioides difficile infection in pediatric wards: a prospective cohort analysis
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2021-11-01
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Abstract
Background. Clostridioides difficile (C. difficile) is a well-known causative agent of healthcare associated infection, it increases medical cost besides increasing morbidity and mortality. This study was conducted to determine the incidence, and economic burden of healthcare facility-onset C. difficile infection (HO-CDI) in children. Methods. Data was acquired with a prospective cohort study conducted in pediatric wards of a tertiary university hospital between August 2015 to August 2016. The HO-CDI was defined as diarrhea that began after 48 hours of admission with a positive cytotoxic stool assay for the presence of toxin A and/or B of C. difficile. Results. In the 3172 admissions in one year, 212 (7%) healthcare associated diarrhea (HAD) episodes were observed, in 25 (12%) of them C. difficile was identified in which 6 (25%) cases <2-year-old. The incidence of HOCDI was estimated as 8.8/10,000 patient-days. Cases with HO-CDI (n=19) were compared with cases with nonCDI-HAD (n=102); the presence of one of the risk factors for CDI increased the risk for HO-CDI (5,05; 95% Cl: 1.10-23.05; P 0,037), the median length of stay (LOS) attributable HO-CDI was 7 days (IQR,5-10) per admission, whereas for non-CDI-HAD was 2 days (IQR,0-4) (p=0.036). General hospitalization costs in the two groups were similar, specifically estimated costs attributable to HO-CDI and non-CID-HAD were $294.0 and $137.0 per Conclusion. Although in children the incidence of HO-CDI is increasing, its clinical manifestation is still milder and effective infection control measures with antibiotic stewardship can limit related morbidly, mortality, LOS, and cost.
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Tıp, Dahili Tıp Bilimleri, Çocuk Sağlığı ve Hastalıkları, Sağlık Bilimleri, Medicine, Internal Medicine Sciences, Child Health and Diseases, Health Sciences, PEDİATRİ, Klinik Tıp, Klinik Tıp (MED), PEDIATRICS, CLINICAL MEDICINE, Clinical Medicine (MED), Pediatri, Pediatri, Perinatoloji ve Çocuk Sağlığı, Pediatrics, Pediatrics, Perinatology and Child Health, health-care, HO-CDI, C, difficile, cost, pediatric, RISK-FACTORS, CHILDREN, BURDEN, COLONIZATION, DISEASE, health-care, HO-CDI, C. difficile, cost, pediatric
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Demir S. O., KEPENEKLİ KADAYİFCİ E., Akkoc G., Yakut N., Soysal A., "Cost and length of hospital stay for healthcare facility-onset Clostridioides Difficile infection in pediatric wards: a prospective cohort analysis", TURKISH JOURNAL OF PEDIATRICS, cilt.63, sa.6, ss.1004-1011, 2021