Control of Clostridium difficile infection in the hospital setting

References

• Zimlichman E, Henderson D, Tamir O, et al. Health care-associated infections: a meta-analysis of costs and financial impact on the US health care system. JAMA Intern Med 2013;173(22):2039-46
   PubMed Web of Science ®Google Scholar
• Miller BA, Chen LF, Sexton DJ, Anderson DJ. Comparison of the burdens of hospital-onset, healthcare facility-associated Clostridium difficile Infection and of healthcare-associated infection due to methicillin-resistant Staphylococcus aureus in community hospitals. Infect Control Hosp Epidemiol 2011;32(4):387-90
   PubMed Web of Science ®Google Scholar
• Department of Health. High impact intervention – care bundle to reduce the risk from Clostridium difficile. Department of Health. 2010. Available from: http://hcai.dh.gov.uk/whatdoido/high-impact-interventions/ [Last accessed 13 December 2013]
   Google Scholar
• Scottish Government. HAI Task Force Annual Report 2011-12. SG. 2012. Available from: www.scotland.gov.uk/Topics/Health/Services/Preventing-Healthcare-Infections/Infection-Monitoring/Taskforce/haitfreport11-12 [Last accessed 16 December 2013]
   Google Scholar
• The US Department of Health and Human Services (HHS). National action plan to prevent health care-associated infections: road map to elimination. HHS. 2013. Available from: www.hhs.gov/ash/initiatives/hai/actionplan/ [Last accessed 16 December 2013]
   Google Scholar
• Association for Professionals in Infection Control and Epidemiology. Guide to preventing Clostridium difficile infections. APIC. 2013. Available from: www.apic.org/Resource_/EliminationGuideForm/e3a85b7e-7ad8-4ab6-9892-54aef516cf10/File/2013CDiffFinal.pdf [Last accessed 16 December 2013]
   Google Scholar
• Bassetti M, Villa G, Pecori D, et al. Epidemiology, diagnosis and treatment of Clostridium difficile infection. Expert Rev Anti Infect Ther 2012;10(12):1405-23
   PubMed Web of Science ®Google Scholar
• Labbe AC, Poirier L, MacCannell D, et al. Clostridium difficile infections in a Canadian tertiary care hospital before and during a regional epidemic associated with the BI/NAP1/027 strain. Antimicrob Agents Chemother 2008;52(9):3180-7
   PubMed Web of Science ®Google Scholar
• Miller M, Gravel D, Mulvey M, et al. Health care-associated Clostridium difficile infection in Canada: patient age and infecting strain type are highly predictive of severe outcome and mortality. Clin Infect Dis 2010;50(2):194-201
   PubMed Web of Science ®Google Scholar
• Sirard S, Valiquette L, Fortier LC. Lack of association between clinical outcome of Clostridium difficile infections, strain type, and virulence-associated phenotypes. J Clin Microbiol 2011;49(12):4040-6
   PubMed Web of Science ®Google Scholar
• Walker AS, Eyre DW, Wyllie DH, et al. Relationship between bacterial strain type, host biomarkers, and mortality in Clostridium difficile infection. Clin Infect Dis 2013;56(11):1589-600
   PubMed Web of Science ®Google Scholar
• Warny M, Pepin J, Fang A, et al. Toxin production by an emerging strain of Clostridium difficile associated with outbreaks of severe disease in North America and Europe. Lancet 2005;366(9491):1079-84
   PubMed Web of Science ®Google Scholar
• Hensgens MP, Goorhuis A, Dekkers OM, Kuijper EJ. Time interval of increased risk for Clostridium difficile infection after exposure to antibiotics. J Antimicrob Chemother 2012;67(3):742-8
   PubMed Web of Science ®Google Scholar
• Kyne L, Warny M, Qamar A, Kelly CP. Asymptomatic carriage of Clostridium difficile and serum levels of IgG antibody against toxin A. N Engl J Med 2000;342(6):390-7
   PubMed Web of Science ®Google Scholar
• Wullt M, Noren T, Ljungh A, Akerlund T. IgG antibody response to toxins A and B in patients with Clostridium difficile infection. Clin Vaccine Immunol 2012;19(9):1552-4
   PubMedGoogle Scholar
• Kyne L, Warny M, Qamar A, Kelly CP. Association between antibody response to toxin A and protection against recurrent Clostridium difficile diarrhoea. Lancet 2001;357(9251):189-93
   PubMed Web of Science ®Google Scholar
• Gerding DN. Global epidemiology of Clostridium difficile infection in 2010. Infect Control Hosp Epidemiol 2010;31(Suppl 1):S32-4
   PubMed Web of Science ®Google Scholar
• Muto CA, Pokrywka M, Shutt K, et al. A large outbreak of Clostridium difficile-associated disease with an unexpected proportion of deaths and colectomies at a teaching hospital following increased fluoroquinolone use. Infect Control Hosp Epidemiol 2005;26(3):273-80
   PubMed Web of Science ®Google Scholar
• McDonald LC, Killgore GE, Thompson A, Jr., et al. An epidemic, toxin gene-variant strain of Clostridium difficile. N Engl J Med 2005;353(23):2433-41
   PubMed Web of Science ®Google Scholar
• Kuijper EJ, Coignard B, Tull P; ESCMID Study Group for Clostridium difficile EMSE. Emergence of Clostridium difficile-associated disease in North America and Europe. Clin Microbiol Infect 2006;12(Suppl 6):2-18
   PubMed Web of Science ®Google Scholar
• Loo VG, Poirier L, Miller MA, et al. A predominantly clonal multi-institutional outbreak of Clostridium difficile-associated diarrhea with high morbidity and mortality. N Engl J Med 2005;353(23):2442-9
   PubMed Web of Science ®Google Scholar
• Dallal RM, Harbrecht BG, Boujoukas AJ, et al. Fulminant Clostridium difficile: an underappreciated and increasing cause of death and complications. Ann Surg 2002;235(3):363-72
   PubMed Web of Science ®Google Scholar
• Pepin J, Valiquette L, Alary ME, et al. Clostridium difficile-associated diarrhea in a region of Quebec from 1991 to 2003: a changing pattern of disease severity. CMAJ 2004;171(5):466-72
   PubMed Web of Science ®Google Scholar
• Kuijper EJ, Coignard B, Brazier JS, et al. Update of Clostridium difficile-associated disease due to PCR ribotype 027 in Europe. Euro Surveill 2007;12(6):E1-2
   PubMedGoogle Scholar
• Coia JE. What is the role of antimicrobial resistance in the new epidemic of Clostridium difficile? Int J Antimicrob Agents 2009;33(Suppl 1):S9-12
   PubMedGoogle Scholar
• He M, Miyajima F, Roberts P, et al. Emergence and global spread of epidemic healthcare-associated Clostridium difficile. Nat Genet 2013;45(1):109-13
   PubMed Web of Science ®Google Scholar
• Daniels K. The rise in Clostridium difficile infections in United States Hospitals, 2001 to 2010. Interscience Conference on Antimicrobial Agents and Chemotherapy. 2013. Available from: www.icaac.org/index.php/submit-your-abstract/45-icaac2012/newsroom/1000018-the-rise-in-clostridium-difficile-infections-in-united-states-hospitals-2001-to-2010 [Last accessed 16 December 2013]
   Google Scholar
• Duerden BI. Contribution of a government target to controlling Clostridium difficile in the NHS in England. Anaerobe 2011;17(4):175-9
   PubMed Web of Science ®Google Scholar
• Miller MA, Hyland M, Ofner-Agostini M, et al. Morbidity, mortality, and healthcare burden of nosocomial Clostridium difficile-associated diarrhea in Canadian hospitals. Infect Control Hosp Epidemiol 2002;23(3):137-40
   PubMed Web of Science ®Google Scholar
• Bauer MP, Notermans DW, van Benthem BH, et al. Clostridium difficile infection in Europe: a hospital-based survey. Lancet 2011;377(9759):63-73
   PubMed Web of Science ®Google Scholar
• Goorhuis A, Bakker D, Corver J, et al. Emergence of Clostridium difficile infection due to a new hypervirulent strain, polymerase chain reaction ribotype 078. Clin Infect Dis 2008;47(9):1162-70
   PubMed Web of Science ®Google Scholar
• Dingle KE, Griffiths D, Didelot X, et al. Clinical Clostridium difficile: clonality and pathogenicity locus diversity. PLoS One 2011;6(5):e19993
   PubMed Web of Science ®Google Scholar
• Health Protection Scotland. The Annual Surveillance of Healthcare Associated Infections Report January - December 2011. HPS. 2012. Available from: www.hps.scot.nhs.uk/haiic/publicationsdetail.aspx?id=51462 [Last accessed 17 December 2013]
   Google Scholar
• Health Protection Agency. Mandatory surveillance of Clostridium difficile. HPA. 2013. Available from: www.hpa.org.uk/web/HPAweb&HPAwebStandard/HPAweb_C/1179746015058 Last accessed 17 December 2013]
   Google Scholar
• Health Protection Scotland. Mandatory surveillance of clostridium difficile infection (CDI) in Scotland. HPS. 2013. Available from: www.hps.scot.nhs.uk/haiic/sshaip/clostridiumdifficile.aspx [Last accessed 17 December 2013]
   Google Scholar
• Kelly CP, LaMont JT. Clostridium difficile infection. Annu Rev Med 1998;49:375-90
   PubMed Web of Science ®Google Scholar
• McFarland LV, Mulligan ME, Kwok RY, Stamm WE. Nosocomial acquisition of Clostridium difficile infection. N Engl J Med 1989;320(4):204-10
   PubMed Web of Science ®Google Scholar
• Wilcox MH, Planche T, Fang FC, Gilligan P. What is the current role of algorithmic approaches for diagnosis of Clostridium difficile infection? J Clin Microbiol 2010;48(12):4347-53
   PubMed Web of Science ®Google Scholar
• Planche TD, Davies KA, Coen PG, et al. Differences in outcome according to Clostridium difficile testing method: a prospective multicentre diagnostic validation study of C difficile infection. Lancet Infect Dis 2013;13(11):936-45
   PubMed Web of Science ®Google Scholar
• Crobach MJ, Dekkers OM, Wilcox MH, Kuijper EJ. European Society of Clinical Microbiology and Infectious Diseases (ESCMID): data review and recommendations for diagnosing Clostridium difficile-infection (CDI). Clin Microbiol Infect 2009;15(12):1053-66
   PubMed Web of Science ®Google Scholar
• Surawicz CM, Brandt LJ, Binion DG, et al. Guidelines for diagnosis, treatment, and prevention of Clostridium difficile infections. Am J Gastroenterol 2013;108(4):478-98
   PubMed Web of Science ®Google Scholar
• Deshpande A, Pasupuleti V, Patel P, et al. Repeat stool testing for Clostridium difficile using enzyme immunoassay in patients with inflammatory bowel disease increases diagnostic yield. Curr Med Res Opin 2012;28(9):1553-60
   PubMed Web of Science ®Google Scholar
• Vonberg RP, Kuijper EJ, Wilcox MH, et al. Infection control measures to limit the spread of Clostridium difficile. Clin Microbiol Infect 2008;14(Suppl 5):2-20
   PubMedGoogle Scholar
• Siegel JD, Rhinehart E, Jackson M, Chiarello L. Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings 2007. Centres for Disease Control and Prevention. 2007. Available from: www.cdc.gov/hicpac/2007IP/2007isolationPrecautions.html [Last accessed 19 September 2011]
   Google Scholar
• Healthcare Commission. Investigation into outbreaks of Clostridium difficile at Stoke Mandeville Hospital, Buckinghamshire Hospitals NHS Trust. Healthcare Commission. 2006. Available from: www.buckshealthcare.nhs.uk/Downloads/healthcarecommision/HCC-Investigation-into-the-Outbreak-of-Clostridium-Difficile.pdf [Last accessed 17 December 2013]
   Google Scholar
• Alcala L, Martin A, Marin M, et al. The undiagnosed cases of Clostridium difficile infection in a whole nation: where is the problem? Clin Microbiol Infect 2012;18(7):E204-13
   PubMed Web of Science ®Google Scholar
• Davies KA. First report from European, multi-centre, prospective bi-annual point prevalence study of Clostridium difficile Infection in hospitalised patients with diarrhoea. ESCMID. 2013. Available from: http://webcache.googleusercontent.com/search?q=cache:zvIyy73uC18J:https://www.escmid.org/escmid_library/online_lecture_library/material/%3Fmid%3D9365+&cd=1&hl=en&ct=clnk&gl=u [Last accessed 17 December 2013]
   Google Scholar
• Center for Disease Control, National Healthcare Safety Network. CDC/NHSN Protocol Clarifications. 2013; CDC/NHSN [ Last accessed 17 December 2013
   Google Scholar
• Benneyan JC. Statistical quality control methods in infection control and hospital epidemiology, part I: Introduction and basic theory. Infect Control Hosp Epidemiol 1998;19(3):194-214
   PubMed Web of Science ®Google Scholar
• Benneyan JC. Statistical quality control methods in infection control and hospital epidemiology, Part II: chart use, statistical properties, and research issues. Infect Control Hosp Epidemiol 1998;19(4):265-83
   PubMed Web of Science ®Google Scholar
• Wilcox MH, Mooney L, Bendall R, et al. A case-control study of community-associated Clostridium difficile infection. J Antimicrob Chemother 2008;62(2):388-96
   PubMed Web of Science ®Google Scholar
• Khanna S, Pardi DS, Aronson SL, et al. The epidemiology of community-acquired Clostridium difficile infection: a population-based study. Am J Gastroenterol 2012;107(1):89-95
   PubMed Web of Science ®Google Scholar
• Marwick CA, Yu N, Lockhart MC, et al. Community-associated Clostridium difficile infection among older people in Tayside, Scotland, is associated with antibiotic exposure and care home residence: cohort study with nested case-control. J Antimicrob Chemother 2013;68(12):2927-33
   PubMed Web of Science ®Google Scholar
• Garg S, Mirza YR, Girotra M, et al. Epidemiology of Clostridium difficile-Associated Disease (CDAD): a Shift from Hospital-Acquired Infection to Long-Term Care Facility-Based Infection. Dig Dis Sci 2013;58(12):3407-12
   PubMed Web of Science ®Google Scholar
• Huhulescu S, Kiss R, Brettlecker M, et al. Etiology of acute gastroenteritis in three sentinel general practices, Austria. 2007. Infection 2009;37(2):103-8
   PubMed Web of Science ®Google Scholar
• Cohen SH, Gerding DN, Johnson S, et al. Clinical practice guidelines for Clostridium difficile infection in adults: 2010 update by the Society for Healthcare Epidemiology of America (SHEA) and the Infectious Diseases Society of America (IDSA). Infect Control Hosp Epidemiol 2010;31(5):431-55
   PubMed Web of Science ®Google Scholar
• Hensgens MP, Keessen EC, Squire MM, et al. Clostridium difficile infection in the community: a zoonotic disease? Clin Microbiol Infect 2012;18(7):635-45
   PubMed Web of Science ®Google Scholar
• Didelot X, Bowden R, Wilson DJ, et al. Transforming clinical microbiology with bacterial genome sequencing. Nat Rev Genet 2012;13(9):601-12
   PubMed Web of Science ®Google Scholar
• Eyre DW, Cule ML, Wilson DJ, et al. Diverse sources of C. difficile infection identified on whole-genome sequencing. N Engl J Med 2013;369(13):1195-205
   PubMed Web of Science ®Google Scholar
• WHO. WHO guidelines on hand hygiene in health care: first global patient safety challenge clean care is safer care. WHO; Geneva, Switzerland: 2009
   Google Scholar
• Jabbar U, Leischner J, Kasper D, et al. Effectiveness of alcohol-based hand rubs for removal of Clostridium difficile spores from hands. Infect Control Hosp Epidemiol 2010;31(6):565-70
   PubMed Web of Science ®Google Scholar
• Oughton MT, Loo VG, Dendukuri N, et al. Hand hygiene with soap and water is superior to alcohol rub and antiseptic wipes for removal of Clostridium difficile. Infect Control Hosp Epidemiol 2009;30(10):939-44
   PubMed Web of Science ®Google Scholar
• Freeman J, Bauer MP, Baines SD, et al. The changing epidemiology of Clostridium difficile infections. Clin Microbiol Rev 2010;23(3):529-49
   PubMed Web of Science ®Google Scholar
• Kelly CP, LaMont JT. Clostridium difficile – more difficult than ever. [Review] [51 refs][Erratum appears in N Engl J Med. 2010 Oct 14;363(16):1585]. N Engl J Med 2008;359(18):1932-40
   PubMed Web of Science ®Google Scholar
• Barbut F, Petit JC. Epidemiology of Clostridium difficile-associated infections. Clin Microbiol Infect 2001;7(8):405-10
   PubMed Web of Science ®Google Scholar
• Loo VG, Bourgault AM, Poirier L, et al. Host and pathogen factors for Clostridium difficile infection and colonization. N Engl J Med 2011;365(18):1693-703
   PubMed Web of Science ®Google Scholar
• Barbut F, Menuet D, Verachten M, Girou E. Comparison of the efficacy of a hydrogen peroxide dry-mist disinfection system and sodium hypochlorite solution for eradication of Clostridium difficile spores. Infect Control Hosp Epidemiol 2009;30(6):507-14
   PubMed Web of Science ®Google Scholar
• Dumford DM 3rd, Nerandzic MM, Eckstein BC, Donskey CJ. What is on that keyboard? Detecting hidden environmental reservoirs of Clostridium difficile during an outbreak associated with North American pulsed-field gel electrophoresis type 1 strains. Am J Infect Control 2009;37(1):15-19
   PubMed Web of Science ®Google Scholar
• Verity P, Wilcox MH, Fawley W, Parnell P. Prospective evaluation of environmental contamination by Clostridium difficile in isolation side rooms. J Hosp Infect 2001;49(3):204-9
   PubMed Web of Science ®Google Scholar
• Wilcox MH. Overcoming barriers to effective recognition and diagnosis of Clostridium difficile infection. Clin Microbiol Infect 2012;18(Suppl 6):13-20
   PubMed Web of Science ®Google Scholar
• Best EL, Sandoe JA, Wilcox MH. Potential for aerosolization of Clostridium difficile after flushing toilets: the role of toilet lids in reducing environmental contamination risk. J Hosp Infect 2012;80(1):1-5
   PubMed Web of Science ®Google Scholar
• Roberts K, Smith CF, Snelling AM, et al. Aerial dissemination of Clostridium difficile spores. BMC Infect Dis 2008;8:7
   PubMed Web of Science ®Google Scholar
• Department of Health, Health Protection Agency. Clostridium difficile infection: how to deal with the problem. Department of Health; London: 2008
   Google Scholar
• Health Protection Network. Guidance on prevention and control of Clostridium difficile infection (CDI) in Care Settings in Scotland. Health Protection Network Scottish Guidance 3. ( 2014 Edition Health Protection Scotland, Glasgow, Scotland; 2014. Available from: www.documents.hps.scot.nhs.uk/about-hps/hpn/clostridium-difficile-infection-guidelines.pdf
   Google Scholar
• Riggs MM, Sethi AK, Zabarsky TF, et al. Asymptomatic carriers are a potential source for transmission of epidemic and nonepidemic Clostridium difficile strains among long-term care facility residents. Clin Infect Dis 2007;45(8):992-8
   PubMed Web of Science ®Google Scholar
• Jinno S, Kundrapu S, Guerrero DM, et al. Potential for transmission of Clostridium difficile by asymptomatic acute care patients and long-term care facility residents with prior C. difficile infection. Infect Control Hosp Epidemiol 2012;33(6):638-9
   PubMed Web of Science ®Google Scholar
• Sethi AK, Al-Nassir WN, Nerandzic MM, et al. Persistence of skin contamination and environmental shedding of Clostridium difficile during and after treatment of C. difficile infection. Infect Control Hosp Epidemiol 2010;31(1):21-7
   PubMed Web of Science ®Google Scholar
• Muto CA, Blank MK, Marsh JW, et al. Control of an outbreak of infection with the hypervirulent Clostridium difficile BI strain in a university hospital using a comprehensive “bundle” approach. Clin Infect Dis 2007;45(10):1266-73
   PubMed Web of Science ®Google Scholar
• Barbut F, Menuet D, Verachten M, Girou E. Comparison of the efficacy of a hydrogen peroxide dry-mist disinfection system and sodium hypochlorite solution for eradication of Clostridium difficile spores. Infect Control Hosp Epidemiol 2009;30(6):507-14
   PubMed Web of Science ®Google Scholar
• Boyce JM, Havill NL, Otter JA, et al. Impact of hydrogen peroxide vapor room decontamination on Clostridium difficile environmental contamination and transmission in a healthcare setting. Infect Control Hosp Epidemiol 2008;29(8):723-9
   PubMed Web of Science ®Google Scholar
• Byrns G, Fuller TP. The risks and benefits of chemical fumigation in the health care environment. J Occup Environ Hyg 2011;8(2):104-12
   PubMed Web of Science ®Google Scholar
• Davies A, Pottage T, Bennett A, Walker J. Gaseous and air decontamination technologies for Clostridium difficile in the healthcare environment. J Hosp Infect 2011;77(3):199-203
   PubMed Web of Science ®Google Scholar
• Dryden M, Parnaby R, Dailly S, et al. Hydrogen peroxide vapour decontamination in the control of a polyclonal meticillin-resistant Staphylococcus aureus outbreak on a surgical ward. J Hosp Infect 2008;68(2):190-2
   PubMed Web of Science ®Google Scholar
• Falagas ME, Thomaidis PC, Kotsantis IK, et al. Airborne hydrogen peroxide for disinfection of the hospital environment and infection control: a systematic review. J Hosp Infect 2011;78(3):171-7
   PubMed Web of Science ®Google Scholar
• Otter JA, Puchowicz M, Ryan D, et al. Feasibility of routinely using hydrogen peroxide vapor to decontaminate rooms in a busy United States hospital. Infect Control Hosp Epidemiol 2009;30(6):574-7
   PubMed Web of Science ®Google Scholar
• Nerandzic MM, Donskey CJ. Triggering germination represents a novel strategy to enhance killing of Clostridium difficile spores. PLoS One 2010;5(8):e12285
   PubMed Web of Science ®Google Scholar
• Nerandzic MM, Cadnum JL, Pultz MJ, Donskey CJ. Evaluation of an automated ultraviolet radiation device for decontamination of Clostridium difficile and other healthcare-associated pathogens in hospital rooms. BMC Infect Dis 2010;10:197
   PubMed Web of Science ®Google Scholar
• Rutala WA, Gergen MF, Weber DJ. Room decontamination with UV radiation. Infection Control & Hospital Epidemiology 2010;31(10):1025-9
   PubMed Web of Science ®Google Scholar
• Tanner BD. Reduction in infection risk through treatment of microbially contaminated surfaces with a novel, portable, saturated steam vapor disinfection system. Am J Infect Control 2009;37(1):20-7
   PubMed Web of Science ®Google Scholar
• Chatuev BM, Peterson JW. Analysis of the sporicidal activity of chlorine dioxide disinfectant against Bacillus anthracis (Sterne strain). J Hosp Infect 2010;74(2):178-83
   PubMed Web of Science ®Google Scholar
• Speight S, Moy A, Macken S, et al. Evaluation of the sporicidal activity of different chemical disinfectants used in hospitals against Clostridium difficile. J Hosp Infect 2011;79(1):18-22
   PubMed Web of Science ®Google Scholar
• Doan L, Forrest H, Fakis A, et al. Clinical and cost effectiveness of eight disinfection methods for terminal disinfection of hospital isolation rooms contaminated with Clostridium difficile 027. J Hosp Infect 2012;82(2):114-21
   PubMed Web of Science ®Google Scholar
• The NHS Scotland national cleaning services specification. Health Facilities Scotland; 2009. Available from: www.hfs.scot.nhs.uk/publications/1265120830-The%20NHSScotland%20National%20Cleaning%20Services%20Specification.pdf [Last accessed 22 September 2011]
   Google Scholar
• Curry SR, Muto CA, Schlakman JL, et al. Use of multilocus variable number of tandem repeats analysis genotyping to determine the role of asymptomatic carriers in Clostridium difficile transmission. Clin Infect Dis 2013;57(8):1094-102
   PubMed Web of Science ®Google Scholar
• Eyre DW, Griffiths D, Vaughan A, et al. Asymptomatic Clostridium difficile Colonisation and Onward Transmission. PLoS One 2013;8(11):e78445
   PubMed Web of Science ®Google Scholar
• Samore MH, Venkataraman L, DeGirolami PC, et al. Clinical and molecular epidemiology of sporadic and clustered cases of nosocomial Clostridium difficile diarrhea. Am J Med 1996;100(1):32-40
   PubMed Web of Science ®Google Scholar
• Bartsch SM, Curry SR, Harrison LH, Lee BY. The potential economic value of screening hospital admissions for Clostridium difficile. Eur J Clin Microbiol Infect Dis 2012;31(11):3163-71
   PubMed Web of Science ®Google Scholar
• Dubberke ER, Gerding DN, Classen D, et al. Strategies to prevent clostridium difficile infections in acute care hospitals. Infect Control Hosp Epidemiol 2008;29(Suppl 1):S81-92
   PubMed Web of Science ®Google Scholar
• Gerding DN, Muto CA, Owens RC Jr. Measures to control and prevent Clostridium difficile infection. Clin Infect Dis 2008;46(Suppl 1)):S43-9
   PubMedGoogle Scholar
• Allerberger F, Gareis R, Jindrak V, Struelens MJ. Antibiotic stewardship implementation in the EU: the way forward. Expert Rev Anti Infect Ther 2009;7(10):1175-83
   PubMed Web of Science ®Google Scholar
• Dellit TH, Owens RC, McGowan JE Jr, et al. Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America guidelines for developing an institutional program to enhance antimicrobial stewardship. Clin Infect Dis 2007;44(2):159-77
   PubMed Web of Science ®Google Scholar
• Davey P, Brown E, Charani E, et al. Interventions to improve antibiotic prescribing practices for hospital inpatients. Cochrane Database Syst Rev 2013;4:CD003543
   PubMed Web of Science ®Google Scholar
• Carling P, Fung T, Killion A, et al. Favorable impact of a multidisciplinary antibiotic management program conducted during 7 years. Infect Control Hosp Epidemiol 2003;24(9):699-706
   PubMed Web of Science ®Google Scholar
• Climo MW, Israel DS, Wong ES, et al. Hospital-wide restriction of clindamycin: effect on the incidence of Clostridium difficile-associated diarrhea and cost. Ann Intern Med 1998;128(12 Pt 1):989-95
   PubMed Web of Science ®Google Scholar
• Khan R, Cheesbrough J. Impact of changes in antibiotic policy on Clostridium difficile-associated diarrhoea (CDAD) over a five-year period in a district general hospital. J Hosp Infect 2003;54(2):104-8
   PubMed Web of Science ®Google Scholar
• McNulty C, Logan M, Donald IP, et al. Successful control of Clostridium difficile infection in an elderly care unit through use of a restrictive antibiotic policy. J Antimicrob Chemother 1997;40(5):707-11
   PubMed Web of Science ®Google Scholar
• Pear SM, Williamson TH, Bettin KM, et al. Decrease in nosocomial Clostridium difficile-associated diarrhea by restricting clindamycin use. Ann Intern Med 1994;120(4):272-7
   PubMed Web of Science ®Google Scholar
• Scottish Intercollegiate Guidelines Network. SIGN Guidelines 104: antibiotic prophylaxis in surgery. SIGN. 2013. Available from: www.sign.ac.uk/pdf/sign104.pdf [Last accessed 17 December 2013]
   Google Scholar
• Muto CA. Why are antibiotic-resistant nosocomial infections spiraling out of control? Infect Control Hosp Epidemiol 2005;26(1):10-12
   PubMed Web of Science ®Google Scholar
• Valiquette L, Cossette B, Garant MP, et al. Impact of a reduction in the use of high-risk antibiotics on the course of an epidemic of Clostridium difficile-associated disease caused by the hypervirulent NAP1/027 strain. Clin Infect Dis 2007;45(Suppl 2):S112-21
   PubMed Web of Science ®Google Scholar
• Fowler S, Webber A, Cooper BS, et al. Successful use of feedback to improve antibiotic prescribing and reduce Clostridium difficile infection: a controlled interrupted time series. J Antimicrob Chemother 2007;59(5):990-5
   PubMed Web of Science ®Google Scholar
• Stone SP, Beric V, Quick A, et al. The effect of an enhanced infection-control policy on the incidence of Clostridium difficile infection and methicillin-resistant Staphyloccocus aureus colonization in acute elderly medical patients. Age Ageing 1998;27(5):561-8
   PubMed Web of Science ®Google Scholar
• Nathwani D, Sneddon J, Malcolm W, et al. Scottish Antimicrobial Prescribing Group (SAPG): development and impact of the Scottish National Antimicrobial Stewardship Programme. Int J Antimicrob Agents 2011;38(1):16-26
   PubMed Web of Science ®Google Scholar
• Nathwani D, Sneddon J, Patton A, Malcolm W. Antimicrobial stewardship in Scotland: impact of a national programme. Antimicrob Resist Infect Control 2012;1(1):7
   PubMed Web of Science ®Google Scholar
• Malcolm W, Nathwani D, Davey P, et al. From intermittent antibiotic point prevalence surveys to quality improvement: experience in Scottish hospitals. Antimicrob Resist Infect Control 2013;2(1):3
   PubMed Web of Science ®Google Scholar
• Ashiru-Oredope D, Sharland M, Charani E, et al. Improving the quality of antibiotic prescribing in the NHS by developing a new Antimicrobial Stewardship Programme: start Smart – Then Focus. J Antimicrob Chemother 2012;67(Suppl 1):i51-63
   PubMedGoogle Scholar
• Health Protection Scotland and Information Services Division. Report on antimicrobial use and resistance in humans in 2011. HPS/ISD. 2012. Available from: www.isdscotland.org/Health-Topics/Prescribing-and-Medicines/Publications/2013-02-26/2013-02-26-SAPG-Report.pdf?661 [Last accessed 17 December 2013]
   Google Scholar
• Aujla RS, Bryson DJ, Gulihar A, Taylor GJ. Trends in orthopaedic antimicrobial prophylaxis in the UK between 2005 and 2011. Ann R Coll Surg Engl 2013;95(7):495-502
   PubMed Web of Science ®Google Scholar
• Lawley TD, Clare S, Walker AW, et al. Antibiotic treatment of Clostridium difficile carrier mice triggers a supershedder state, spore-mediated transmission, and severe disease in immunocompromised hosts. Infect Immun 2009;77(9):3661-9
   PubMed Web of Science ®Google Scholar
• Gens KD, Elshaboury RH, Holt JS. Fecal microbiota transplantation and emerging treatments for Clostridium difficile infection. J Pharm Pract 2013;26(5):498-505
   PubMedGoogle Scholar
• Antharam VC, Li EC, Ishmael A, et al. Intestinal dysbiosis and depletion of butyrogenic bacteria in Clostridium difficile infection and nosocomial diarrhea. J Clin Microbiol 2013;51(9):2884-92
   PubMed Web of Science ®Google Scholar
• Brandt LJ. American Journal of Gastroenterology Lecture: Intestinal microbiota and the role of fecal microbiota transplant (FMT) in treatment of C. difficile infection. Am J Gastroenterol 2013;108(2):177-85
   PubMed Web of Science ®Google Scholar
• Sunenshine RH, McDonald LC. Clostridium difficile-associated disease: new challenges from an established pathogen. Cleve Clin J Med 2006;73(2):187-97
   PubMed Web of Science ®Google Scholar