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Potential causal effect of contact precautions and isolation on Clostridioides difficile infection in the hyperendemic setting: Interrupted time-series analyses before and after implementation

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dc.contributor.author송영구-
dc.contributor.author이경화-
dc.contributor.author이혜선-
dc.contributor.author한상훈-
dc.contributor.author이은화-
dc.date.accessioned2023-11-07T07:40:29Z-
dc.date.available2023-11-07T07:40:29Z-
dc.date.issued2023-10-
dc.identifier.issn1684-1182-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/196489-
dc.description.abstractBackground: Recent studies disputed the effectiveness of efforts to comply with contact precautions and isolation (CPI) considering relatively low intra-hospital transmission rate of healthcare facility-associated Clostridioides difficile infection (HCFA-CDI). We evaluated the potential causal effect of CPI on HCFA-CDI occurrence by comparing the incidence rate (IR) for different time periods with and without CPI implementation. Methods: Long-term observational time-series data were separated into three periods (pre-CPI: January 2012-March 2016, CPI: April 2016-April 2021, post-CPI: May 2021-December 2022). CPI was suspended owing to the restriction of isolation rooms during the COVID-19 pandemic. We inferred potential causal outcomes by comparing predicted and observed IRs of HCFA-CDI using interrupted time-series analyses, including the Bayesian structural time-series or autoregressive integrated moving average (ARIMA) model in the R-language or SAS software. Results: The monthly observed IR (44.9/100,000 inpatient-days) during the CPI period was significantly lower than the predicted IR (90.8) (-50.6% relative effect, P = 0.001). However, the observed IR (52.3) during the post-CPI period was significantly higher than the predicted IR (39.1) (33.6%, P = 0.001). The HCFA-CDI IR decreased during CPI (-14.3, P < 0.001) and increased post-CPI (5.4, P < 0.001) in the multivariable ARIMA model, which controlled for antibiotic usage, handwashing with soap and water, and number of toxin tests. Conclusions: Various time-series models revealed that CPI implementation had a potential causal effect on the reduction of HCFA-CDI incidence.-
dc.description.statementOfResponsibilityopen-
dc.formatapplication/pdf-
dc.languageEnglish, Chinese-
dc.publisherElsevier for the Taiwan Society of Microbiology-
dc.relation.isPartOfJOURNAL OF MICROBIOLOGY IMMUNOLOGY AND INFECTION-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.subject.MESHBayes Theorem-
dc.subject.MESHCOVID-19* / epidemiology-
dc.subject.MESHCOVID-19* / prevention & control-
dc.subject.MESHClostridioides difficile*-
dc.subject.MESHClostridium Infections* / epidemiology-
dc.subject.MESHClostridium Infections* / prevention & control-
dc.subject.MESHCross Infection* / epidemiology-
dc.subject.MESHCross Infection* / prevention & control-
dc.subject.MESHHumans-
dc.subject.MESHPandemics-
dc.titlePotential causal effect of contact precautions and isolation on Clostridioides difficile infection in the hyperendemic setting: Interrupted time-series analyses before and after implementation-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Internal Medicine (내과학교실)-
dc.contributor.googleauthorEun Hwa Lee-
dc.contributor.googleauthorHye Sun Lee-
dc.contributor.googleauthorKyoung Hwa Lee-
dc.contributor.googleauthorYoung Goo Song-
dc.contributor.googleauthorSang Hoon Han-
dc.identifier.doi10.1016/j.jmii.2023.06.003-
dc.contributor.localIdA02037-
dc.contributor.localIdA04620-
dc.contributor.localIdA03312-
dc.contributor.localIdA04286-
dc.relation.journalcodeJ01595-
dc.identifier.eissn1995-9133-
dc.identifier.pmid37380552-
dc.subject.keywordClostridioides difficile-
dc.subject.keywordContact precaution-
dc.subject.keywordIncidence-
dc.subject.keywordIsolation-
dc.subject.keywordTime-series analysis-
dc.contributor.alternativeNameSong, Young Goo-
dc.contributor.affiliatedAuthor송영구-
dc.contributor.affiliatedAuthor이경화-
dc.contributor.affiliatedAuthor이혜선-
dc.contributor.affiliatedAuthor한상훈-
dc.citation.volume56-
dc.citation.number5-
dc.citation.startPage1054-
dc.citation.endPage1063-
dc.identifier.bibliographicCitationJOURNAL OF MICROBIOLOGY IMMUNOLOGY AND INFECTION, Vol.56(5) : 1054-1063, 2023-10-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers

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