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The Impact of Recurrent Clostridium difficile Infection on Patients’ Prevention Behaviors

Published online by Cambridge University Press:  26 September 2017

Frances M. Weaver ,
William E. Trick ,
Charlesnika T. Evans ,
Michael Y. Lin ,
William Adams ,
Mai T. Pho ,
Susan C. Bleasdale ,
Kathleen M. Mullane ,
Stuart Johnson  and
Monica K. Sikka
...Show all authors
Frances M. Weaver*
Affiliation:
Public Health Sciences, Loyola University, Chicago, Illinois Center of Innovation for Complex Chronic Healthcare (CINCCH), Hines Veterans Affairs Hospital, Hines, Illinois
William E. Trick
Affiliation:
Department of Medicine, Cook County Health & Hospitals System, Rush University Medical Center, Chicago, Illinois
Charlesnika T. Evans
Affiliation:
Center of Innovation for Complex Chronic Healthcare (CINCCH), Hines Veterans Affairs Hospital, Hines, Illinois Department of Preventive Medicine, Northwestern University, Chicago, Illinois
Michael Y. Lin
Affiliation:
Center for Health Care Studies, Institute for Public Health and Medicine, Northwestern University, Chicago, Illinois Division of Infectious Diseases, Rush University Medical Center, Chicago, Illinois
William Adams
Affiliation:
Health Sciences Division, Loyola University, Maywood, Illinois
Mai T. Pho
Affiliation:
Division of Infectious Diseases and Global Health, Department of Medicine, University of Chicago, Chicago, Illinois
Susan C. Bleasdale
Affiliation:
Division of Infectious Diseases, College of Medicine, University of Illinois at Chicago, Chicago, Illinois Department of Medicine, Jesse Brown Veterans Affairs Medical Center, Chicago, Illinois
Kathleen M. Mullane
Affiliation:
Division of Infectious Diseases and Global Health, Department of Medicine, University of Chicago, Chicago, Illinois
Stuart Johnson
Affiliation:
Division of Infectious Diseases, Loyola University Medical Center, Chicago, Illinois Research Service and Infectious Disease Section, Edward Hines, Jr., Veterans Affairs Hospital, Hines, Illinois
Monica K. Sikka
Affiliation:
Division of Infectious Diseases, College of Medicine, University of Illinois at Chicago, Chicago, Illinois Department of Medicine, Jesse Brown Veterans Affairs Medical Center, Chicago, Illinois
Lance R. Peterson
Affiliation:
Department of Clinical Microbiology and Infectious Diseases, NorthShore University Health System, Evanston, Illinois
Anthony E. Solomonides
Affiliation:
Department of Family Medicine, NorthShore University Health System, Evanston, Illinois Ambulatory Primary Care Innovations Group, NorthShore University Health System, Evanston, Illinois
Dale N. Gerding
Affiliation:
Edward Hines, Jr., Veterans Affairs Hospital, Hines, Illinois
*
Address correspondence to Frances M. Weaver, PhD, Public Health Sciences, Loyola University Health Sciences Campus, 2150 S First Ave, Maywood, IL 60152 (fweaver@luc.edu).
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Abstract

OBJECTIVE

To determine the impact of recurrent Clostridium difficile infection (RCDI) on patient behaviors following illness.

METHODS

Using a computer algorithm, we searched the electronic medical records of 7 Chicago-area hospitals to identify patients with RCDI (2 episodes of CDI within 15 to 56 days of each other). RCDI was validated by medical record review. Patients were asked to complete a telephone survey. The survey included questions regarding general health, social isolation, symptom severity, emotional distress, and prevention behaviors.

RESULTS

In total, 119 patients completed the survey (32%). On average, respondents were 57.4 years old (standard deviation, 16.8); 57% were white, and ~50% reported hospitalization for CDI. At the time of their most recent illness, patients rated their diarrhea as high severity (58.5%) and their exhaustion as extreme (30.7%). Respondents indicated that they were very worried about getting sick again (41.5%) and about infecting others (31%). Almost 50% said that they have washed their hands more frequently (47%) and have increased their use of soap and water (45%) since their illness. Some of these patients (22%–32%) reported eating out less, avoiding certain medications and public areas, and increasing probiotic use. Most behavioral changes were unrelated to disease severity.

CONCLUSION

Having had RCDI appears to increase prevention-related behaviors in some patients. While some behaviors are appropriate (eg, handwashing), others are not supported by evidence of decreased risk and may negatively impact patient quality of life. Providers should discuss appropriate prevention behaviors with their patients and should clarify that other behaviors (eg, eating out less) will not affect their risk of future illness.

Infect Control Hosp Epidemiol. 2017;38:1351–1357

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 38 , Issue 11 , November 2017 , pp. 1351 - 1357
Copyright
© 2017 by The Society for Healthcare Epidemiology of America. All rights reserved 

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