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Underdiagnosis of Clostridium difficile across Europe: the European, multicentre, prospective, biannual, point-prevalence study of Clostridium difficile infection in hospitalised patients with diarrhoea (EUCLID)

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dc.contributor.authorDavies, K.A.
dc.contributor.authorLongshaw, C.M.
dc.contributor.authorDavis, G.
dc.contributor.authorBouza, E.
dc.contributor.authorBarbut, F.
dc.contributor.authorBarna, Z.
dc.contributor.authorDelmée, M.
dc.contributor.authorFitzpatrick, F.
dc.contributor.authorIvanova, K.
dc.contributor.authorKuipjer, E.
dc.contributor.authorMacovei, I.S.
dc.contributor.authorMentula, S.
dc.contributor.authorMastrantonio, P.
dc.contributor.authorvon Müller, L.
dc.contributor.authorOleastro, M.
dc.contributor.authorPetinaki, E.
dc.contributor.authorPituch, H.
dc.contributor.authorNorén, T.
dc.contributor.authorNováková, E.
dc.contributor.authorNyc, O.
dc.contributor.authorRupnik, M.
dc.contributor.authorSchmid, D.
dc.contributor.authorWilcox, M.H.
dc.date.accessioned2015-02-19T13:39:18Z
dc.date.available2015-02-19T13:39:18Z
dc.date.issued2014-12
dc.descriptionComment in: Hidden burden of undiagnosed Clostridium difficile infection. [Lancet Infect Dis. 2014]por
dc.description.abstractBACKGROUND: Variations in testing for Clostridium difficile infection can hinder patients' care, increase the risk of transmission, and skew epidemiological data. We aimed to measure the underdiagnosis of C difficile infection across Europe. METHODS: We did a questionnaire-based study at 482 participating hospitals across 20 European countries. Hospitals were questioned about their methods and testing policy for C difficile infection during the periods September, 2011, to August, 2012, and September, 2012, to August, 2013. On one day in winter, 2012-13 (December, 2012, or January, 2013), and summer, 2013 (July or August), every hospital sent all diarrhoeal samples submitted to their microbiology laboratory to a national coordinating laboratory for standardised testing of C difficile infection. Our primary outcome measures were the rates of testing for and cases of C difficile infection per 10 000 patient bed-days. Results of local and national C difficile infection testing were compared with each other. If the result was positive at the national laboratory but negative at the local hospital, the result was classified as undiagnosed C difficile infection. We compared differences in proportions with the Mann-Whitney test, or McNemar's test if data were matched. FINDINGS: During the study period, participating hospitals reported a mean of 65·8 tests (country range 4·6-223·3) for C difficile infection per 10 000 patient-bed days and a mean of 7·0 cases (country range 0·7-28·7) of C difficile infection per 10 000 patient-bed days. Only two-fifths of hospitals reported using optimum methods for testing of C difficile infection (defined by European guidelines), although the number of participating hospitals using optimum methods increased during the study period, from 152 (32%) of 468 in 2011-12 to 205 (48%) of 428 in 2012-13. Across all 482 European hospitals on the two sampling days, 148 (23%) of 641 samples positive for C difficile infection (as determined by the national laboratory) were not diagnosed by participating hospitals because of an absence of clinical suspicion, equating to about 74 missed diagnoses per day. INTERPRETATION: A wide variety of testing strategies for C difficile infection are used across Europe. Absence of clinical suspicion and suboptimum laboratory diagnostic methods mean that an estimated 40 000 inpatients with C difficile infection are potentially undiagnosed every year in 482 European hospitals.por
dc.description.sponsorshipAstellas Pharmaceuticals Europepor
dc.identifier.citationLancet Infect Dis. 2014 Dec;14(12):1208-19. doi: 10.1016/S1473-3099(14)70991-0. Epub 2014 Nov 7por
dc.identifier.doi10.1016/S1473-3099(14)70991-0
dc.identifier.issn1473-3099
dc.identifier.urihttp://hdl.handle.net/10400.18/2921
dc.language.isoengpor
dc.peerreviewedyespor
dc.publisherElsevierpor
dc.relation.publisherversionhttp://www.sciencedirect.com/science/article/pii/S1473309914709910por
dc.subjectClostridium Difficilepor
dc.subjectUnderdiagnosispor
dc.subjectEuropean Studypor
dc.subjectInfecções Gastrointestinaispor
dc.titleUnderdiagnosis of Clostridium difficile across Europe: the European, multicentre, prospective, biannual, point-prevalence study of Clostridium difficile infection in hospitalised patients with diarrhoea (EUCLID)por
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage1219por
oaire.citation.startPage1208por
oaire.citation.titleLancet Infectious Diseasespor
oaire.citation.volume14(12)por
rcaap.rightsembargoedAccesspor
rcaap.typearticlepor

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