Journal article Open Access

Interfacility patient sharing and Clostridioides difficile infection incidence in the Ontario hospital system: A 13-year cohort study

Brown, Kevin A.; McGeer, Allison; Schwartz, Kevin L.; Diong, Christina; Etches, Jacob; Garber, Gary; Johnstone, Jennie; Langford, Bradley; Daneman, Nick


JSON Export

{
  "files": [
    {
      "links": {
        "self": "https://zenodo.org/api/files/0bdf86c9-4184-4cf0-a34f-61c07368cbfa/article.pdf"
      }, 
      "checksum": "md5:a708cfd43209f7650502fea25cfeffe4", 
      "bucket": "0bdf86c9-4184-4cf0-a34f-61c07368cbfa", 
      "key": "article.pdf", 
      "type": "pdf", 
      "size": 481983
    }
  ], 
  "owners": [
    13380
  ], 
  "doi": "10.1017/ice.2019.283", 
  "stats": {
    "version_unique_downloads": 1.0, 
    "unique_views": 4.0, 
    "views": 8.0, 
    "version_views": 8.0, 
    "unique_downloads": 1.0, 
    "version_unique_views": 4.0, 
    "volume": 481983.0, 
    "version_downloads": 1.0, 
    "downloads": 1.0, 
    "version_volume": 481983.0
  }, 
  "links": {
    "doi": "https://doi.org/10.1017/ice.2019.283", 
    "latest_html": "https://zenodo.org/record/3666980", 
    "bucket": "https://zenodo.org/api/files/0bdf86c9-4184-4cf0-a34f-61c07368cbfa", 
    "badge": "https://zenodo.org/badge/doi/10.1017/ice.2019.283.svg", 
    "html": "https://zenodo.org/record/3666980", 
    "latest": "https://zenodo.org/api/records/3666980"
  }, 
  "created": "2020-02-14T03:19:14.449941+00:00", 
  "updated": "2020-02-14T07:20:52.647423+00:00", 
  "conceptrecid": "3666979", 
  "revision": 2, 
  "id": 3666980, 
  "metadata": {
    "access_right_category": "success", 
    "doi": "10.1017/ice.2019.283", 
    "description": "Objective: Interfacility patient movement plays an important role in the dissemination of antimicrobial-resistant organisms throughout healthcare systems. We evaluated how 3 alternative measures of interfacility patient sharing were associated with C. difficile infection incidence in Ontario acute-care facilities.   \n\nDesign: The cohort included adult acute-care facility stays of \u22653 days between April 2003 and March 2016. We measured 3 facility-level metrics of patient sharing: general patient importation, incidence-weighted patient importation, and C. difficile case importation. Each of the 3 patient-sharing metrics were examined against the incidence of C. difficile infection in the facility per 1,000 stays, using Poisson regression models.   \n\nResults: The analyzed cohort included 6.70 million stays at risk of C. difficile infection across 120 facilities. Over the 13-year period, we included 62,189 new cases of healthcare-associated CDI (incidence, 9.3 per 1,000 stays). After adjustment for facility characteristics, general importation was not strongly associated with C. difficile infection incidence (risk ratio [RR] per doubling, 1.10; 95% confidence interval [CI], 0.97\u20131.24; proportional change in variance [PCV], \u22122.0%). Incidence-weighted (RR per doubling, 1.18; 95% CI, 1.06\u20131.30; PCV, \u22128.4%) and C. difficile case importation (RR per doubling, 1.43; 95% CI, 1.29\u20131.58; PCV, \u221230.1%) were strongly associated with C. difficile infection incidence.   \n\nConclusions: In this 13-year study of acute-care facilities in Ontario, interfacility variation in C. difficile infection incidence was associated with importation of patients from other high-incidence acute-care facilities or specifically of patients with a recent history of C. difficile infection. Regional infection control strategies should consider the potential impact of importation of patients at high risk of C. difficile shedding from outside facilities.", 
    "license": {
      "id": "zenodo-freetoread-1.0"
    }, 
    "title": "Interfacility patient sharing and Clostridioides difficile infection incidence in the Ontario hospital system: A 13-year cohort study", 
    "relations": {
      "version": [
        {
          "count": 1, 
          "index": 0, 
          "parent": {
            "pid_type": "recid", 
            "pid_value": "3666979"
          }, 
          "is_last": true, 
          "last_child": {
            "pid_type": "recid", 
            "pid_value": "3666980"
          }
        }
      ]
    }, 
    "publication_date": "2019-11-25", 
    "creators": [
      {
        "orcid": "0000-0002-1483-2188", 
        "name": "Brown, Kevin A."
      }, 
      {
        "name": "McGeer, Allison"
      }, 
      {
        "name": "Schwartz, Kevin L."
      }, 
      {
        "name": "Diong, Christina"
      }, 
      {
        "name": "Etches, Jacob"
      }, 
      {
        "name": "Garber, Gary"
      }, 
      {
        "name": "Johnstone, Jennie"
      }, 
      {
        "name": "Langford, Bradley"
      }, 
      {
        "name": "Daneman, Nick"
      }
    ], 
    "access_right": "open", 
    "resource_type": {
      "subtype": "article", 
      "type": "publication", 
      "title": "Journal article"
    }
  }
}
8
1
views
downloads
Views 8
Downloads 1
Data volume 482.0 kB
Unique views 4
Unique downloads 1

Share

Cite as