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Utilizing rapid multiple-locus variable-number tandem-repeat analysis typing to aid control of hospital-acquired Clostridium difficile Infection: a multicenter study.

Hardy, Katherine J and Manzoor, Susan and Marriott, Claire and Parsons, Helen and Waddington, Claire and Gossain, Savita and Szczepura, Ala and Stallard, Nigel and Hawkey, Peter M (2012) Utilizing rapid multiple-locus variable-number tandem-repeat analysis typing to aid control of hospital-acquired Clostridium difficile Infection: a multicenter study. Journal of clinical microbiology, 50 (10). pp. 3244-8. ISSN 1098-660X. This article is accessible to all HEFT staff and students via NHS Evidence www.evidence.nhs.uk by using their Athens login IDs

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Abstract

The early identification of outbreaks is crucial for the control of Clostridium difficile infection. This study aimed to determine if the number of hospital-acquired C. difficile infections could be reduced by rapidly typing C. difficile strains using multiple-locus variable-number tandem-repeat analysis (MLVA) compared to typing using PCR ribotyping. A total of 16 hospitals were recruited to the study, and all periods of increased incidence (PIIs) of C. difficile infection were identified. The hospitals were randomized into two study arms, the test and the control, with all isolates typed in the test using MLVA and in the control using PCR ribotyping. Following a PII, each hospital received a structured questionnaire regarding control measures implemented or stopped prior to or following the typing results. During the study period, there were a total of 1,682 hospital-apportioned C. difficile toxin-positive cases, with 868 in the control and 814 in the test, with modeling demonstrating no differences between the two arms. A total of 245 PIIs occurred, involving 785 patients. There was a significant difference in the mean turnaround time between the ribotyping and MLVA typing (13.6 and 5.3 days, respectively [P < 0.001]). The discriminatory ability of MLVA was greater than ribotyping, with 85 outbreaks being confirmed by ribotyping and 62 by MLVA. In the test arm, 40.6% of respondents strongly agreed that the typing result had aided their management of clusters, as opposed to 9.9% in the control. The study demonstrated the utility of rapidly typing C. difficile strains, demonstrating that it aided the management of clusters, enabling effective targeting of infection control resources.

Item Type: Article
Additional Information: This article is accessible to all HEFT staff and students via NHS Evidence www.evidence.nhs.uk by using their Athens login IDs
Subjects: WC Communicabable diseases
Divisions: Clinical Support > Pathology
Related URLs:
Depositing User: Mrs Yolande Brookes
Date Deposited: 11 Jul 2014 12:34
Last Modified: 10 Jul 2015 10:54
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/433

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