?url_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Adc&rft.relation=http%3A%2F%2Fd-scholarship-dev.library.pitt.edu%2F34102%2F&rft.title=Clostridium+difficile+infection+spread+within+the+hospital+environment&rft.creator=Rangachar+Srinivasa%2C+Vatsala&rft.description=Background%3A+Clostridium+difficile+Infection+(CDI)+is+one+of+the+leading+causes+of+hospital-associated+infections+(HAIs)+and+accounts+for+nearly+half+a+million+infections+in+the+United+States+(2015).+It+was+associated+with+approximately+29%2C000+deaths+nationwide+in+2011.+This+study+focusses+on+the+role+of+the+environment+in+the+spread+of+CDI+within+a+hospital+in+a+non-outbreak+setting.%0D%0A%0D%0AStatement+of+public+health+significance%3A+The+Centers+for+Disease+Control+and+Prevention+(CDC)+classifies+CDI+threat+rate+as+five%2C+which+requires+urgent+and+aggressive+public+health+action%2C+because+CDI+is+associated+with+significant+morbidity+and+mortality.+Also%2C+the+hospitalization+costs+associated+with+CDI+increase+by+over+50%25.%0D%0A%0D%0AMethod%3A+This+study+was+conducted+at+a+495-+bed+academic+University-affiliated+single+center.+The+first+step+includes+the+performance+of+bed+tracing+on+all+positive+CDI+admitted+patients+in+the+year+2016.+The+second+step+included+the+collection+of+environmental+cultures+of+the+immediate+patient+surrounding+shared+devices+and+floors+to+identify+lapses+in+environmental+cleaning.+Aerobic+environmental+cultures+were+performed+for+CDI+followed+by+Gram+stain+and+anaerobic+confirmatory+culture.+Both+biochemical+and+molecular+testing+was+used+to+confirm+Clostridium+difficile+(CD)+presence.+%0D%0A%0D%0AResults%3A+Bed+tracing+was+performed+for+115+hospital-associated+(HA)-+and+96+community-associated+(CA)-+CDI+patients.+Initial+analysis+between+HA-CDI+and+CA-CDI+revealed+that+the+length+of+stay+was+significantly+longer+in+HA-CDIs.+However%2C+readmission+and+recurrence+were+significantly+higher+in+CA-CDIs.+Bed-tracing+showed+a+limited+list+of+high+burden+rooms.+Environmental+Cultures+revealed+only+2+out+of+81+surfaces%2C+14+out+of+28+floors+%26+3+out+of+20+wheelchairs+as+positive+for+CD+spores.+None+of+these+patients%E2%80%99+rooms+had+active+CDI+patients.+%0D%0A%0D%0AConclusion%3A+Bed+tracing+and+environmental+culturing+are+important+public+health+tools+for+recognizing+rooms+with+high+density+of+CDI+and+are+particularly+important+in+outbreak+settings+or+any+increase+in+incidence.+Shared+devices+(such+as+wheel+chairs)+and+floors+of+patients%E2%80%99+rooms+could+serve+as+a+reservoir+for+CD+spores.+Routine+monitoring+of+disinfection+adequacy+of+shared+devices+and+floors+is+an+important+step+to+assure+a+safe+patient+environment.&rft.date=2018-06-28&rft.type=University+of+Pittsburgh+ETD&rft.type=PeerReviewed&rft.format=application%2Fpdf&rft.language=en&rft.identifier=http%3A%2F%2Fd-scholarship-dev.library.pitt.edu%2F34102%2F1%2FRangacharSrinivasa_Vatsala_MPH_Apr_2018.pdf&rft.identifier=++Rangachar+Srinivasa%2C+Vatsala++(2018)+Clostridium+difficile+infection+spread+within+the+hospital+environment.++Master's+Thesis%2C+University+of+Pittsburgh.++++(Unpublished)++