The impact of toxigenic culture on antimicrobial prescriptions for Clostridioides difficile infection: The role of diagnostic stewardship.

• Material Type: 博士論文
• ISSN: 1345-0069
• Title: The impact of toxigenic culture on antimicrobial prescriptions for Clostridioides difficile infection: The role of diagnostic stewardship.
• Volume: 72 4,5,6
• Author/Editor: Sang-Tae, Lee; Tanaka, Shinobu; Yamazaki, Masaharu; Inoue, Takashi; Kasahara, Kei
• Author Heading: Sang-Tae, Lee; Tanaka, Shinobu; Yamazaki, Masaharu; Inoue, Takashi; Kasahara, Kei
• Publication, Distribution, etc.: 奈良医学会
• Publication Date: 2021-11-30; 72 4,5,6
• Publication Date (W3CDTF): 2021-11-30
• Alternative Title: 毒素培養がClostridioides difficile感染症の抗菌薬処方に与える影響 : diagnostic stewardshipの役割
• Periodical title: Journal of Nara Medical Association
• Degree grantor/type: 奈良県立医科大学
• Date Granted: 2022-03-15
• Date Granted (W3CDTF): 2022-03-15
• Dissertation Number: 乙第1525号
• Degree Type: 博士（医学）
• Conferring No. (Dissertation): 乙第1525号
• Text Language Code: eng
• Subject Heading: Clostridioides difficile infection (CDI); toxigenic culture; diagnostic stewardship
• Target Audience: 一般
• Note (General): type:Thesis; Introduction : Toxigenic culture has been recommended as a sensitivity enhancement option for testing Clostridioides difficile infections (CDI). However, no studies have evaluated whether toxigenic culture impacts clinical decisions such as CDI treatment. Methods : At Nara Medical University Hospital, simultaneous testing of glutamate dehydrogenase antigen (A) and toxin A/B (T) by immunochromatography has been conducted since November 2013. Furthermore, toxigenic culture (C) has been adopted since April 2018. Therefore, patients tested for CD were divided into two groups: pre-period from April 2014 to March 2018 and post-period from April 2018 to March 2021. Patient data were retrospectively examined. Results : The study included 1262 and 1023 cases in the pre- and post-periods, respectively. A significant reduction in A+T+ cases could be observed with 64 (5.1 %) and 28 (2.7%) in the pre- and post-periods (P = 0.005), respectively. Of the 104 A+T- cases undergoing toxigenic culture in the post-period, 54 (51.9 %) were A+T-C+. The antimicrobial administration ratio for the A+T-C+ cases (68.5 %) was lower than that for the A+T+ patients (90.6 and 82.1 %, P = 0.014 and P = 0.417, in the pre- and post-periods, respectively), and was not significantly different from that of the A+T-patients (64.2 and 64.1 % in the pre- and post-periods, respectively) or from that of the A+ T-C-patients (64 %). Conclusion : This study showed that toxigenic culture does not necessarily affect the antibiotic administration ratio or duration. A coordinated approach under diagnostic stewardship for improved reporting and interpretation of toxigenic cultures would be necessary.; 博士（医学）・乙第1525号・令和4年3月15日; identifier:Journal of Nara Medical Association Vol.72 No.4,5,6 p.43-50 (2021.11); identifier:13450069; identifier:http://ginmu.naramed-u.ac.jp/dspace/handle/10564/4030; identifier:Journal of Nara Medical Association, 72(4,5,6): 43-50
• Persistent ID (NDL): info:ndljp/pid/12304455; https://dl.ndl.go.jp/pid/12304455
• Collection: 障害者向け資料
• Collection (Materials For Handicapped People:1): テキストデータ
• Collection (particular): 国立国会図書館デジタルコレクション > デジタル化資料 > 博士論文; https://dl.ndl.go.jp/collections/A00014
• Acquisition Basis: 博士論文（自動収集）
• Date Accepted (W3CDTF): 2022-07-05T02:30:21+09:00
• Format (IMT): PDF; application/pdf
• Access Restrictions: 国立国会図書館内限定公開
• Service for the Digitized Contents Transmission Service: 図書館・個人送信対象外
• Availability of remote photoduplication service: 可
• Periodical Title (URI): http://hdl.handle.net/10564/4030
• Data Provider (Database): 国立国会図書館 : 国立国会図書館デジタルコレクション; https://dl.ndl.go.jp

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