European survey on the current surveillance practices, management guidelines, treatment pathways, and heterogeneity of testing of Clostridioides difficile, 2018-2019: results from The Combatting Bacterial Resistance in Europe CDI (COMBACTE-CDI)
COMBACTE-CDI consortium
(2023) The journal of Hospital Infection, volume 131, pp. 213 - 220
(Article)
Abstract
Background: Awareness and compliance with international guidelines for diagnosis and clinical management of Clostridioides difficile infection (CDI) are unknown. Aim: To compare the awareness and compliance with the recommended strategies for diagnosis and clinical management of CDI across Europe in 2018–2019. Methods: Hospital sites and their associated community practices across
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12 European countries completed an online survey in 2018–2019, to report on their practices in terms of surveillance, prevention, diagnosis, and treatment of CDI. Responses were collected from 105 hospitals and 39 community general practitioners (GPs). Findings: Hospital sites of 11 countries reported participation in national surveillance schemes compared with six countries for international schemes. The European Society of Clinical Microbiology and Infectious Diseases (ESCMID)-recommended CDI testing methodologies were used by 82% (86/105) of hospitals, however countries reporting the highest incidence of CDI used non-recommended tests. Over 75% (80/105) of hospitals were aware of the most recent European CDI treatment guidelines at the time of this survey compared with only 26% (10/39) of surveyed GPs. However, up to 15% (16/105) of hospitals reported using the non-recommended metronidazole for recurrent CDI cases, sites in countries with lower awareness of CDI treatment guidelines. Only 37% (39/105) of hospitals adopted contact isolation precautions in case of suspected CDI. Conclusion: Good awareness of guidelines for the management of CDI was observed across the surveyed European hospital sites. However, low compliance with diagnostic testing guidelines, infection control measures for suspected CDI, and insufficient awareness of treatment guidelines continued to be reported in some countries.
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Keywords: Clostridioides difficile, Clostridium difficile, Diagnosis, Guidelines awareness, Treatment, Microbiology (medical), Infectious Diseases, Journal Article
ISSN: 0195-6701
Publisher: W.B. Saunders Ltd
Note: Funding Information: The COMBACTE- CDI study was supported by Innovative Medicines Initiative 2 Joint Undertaking under grant agreement no. 777362 resources of which are composed of financial contribution from the European Union's Horizon 2020 research and innovation programme, and EFPIA . The funder contributed financially to study design but did not contribute to data collection, analysis, interpretation, preparation of the manuscript or the decision to publish. Funding Information: M.W.H. reports research support grants received by institution from Almirall, Da Volterra, EnteroBiotix, GSK , Merck , MicroPharm, Nabriva, Paratek, Pfizer , Seres, Summit, The European Tissue Symposium and Tillots. M.W.H. has received consulting fees from AiCuris, Bayer , Crestone, Da Volterra, Deinove, Enterobiotix, The European Tissue Symposium, Ferring , GSK , Menarini, Merck , Nestlé, Paion, Paratek, Pfizer , Phico therapeutics, Opex, Biopharma, Seres, Surface Skins, Summit, Tillotts, and Vaxxilon/ Idorsia . M.W.H. has received lecture fees from Merck , Pfizer , Seres, and Tillotts. N.P. has received payment from MSD , Pfizer , ImmuneMed, Novartis , B&D, GSK , J&J, Thermofisher, Roche , and Tillots. K.D. reports grant funding held by institution from Techlab Inc and Cepheid Inc. All authors report funding for the COMBACTE- CDI study as indicated in the funding statement. Publisher Copyright: © 2022 The Author(s)
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