posted on 2017-01-23, 11:16authored byJ. M. Aguado, V. J. Anttila, T. Galperine, S. D. Goldenberg, S. Gwynn, D. Jenkins, T. Norén, N. Petrosillo, H. Seifert, A. Stallmach, T. Warren, C. Wenisch, CDI Consensus Consortium
BACKGROUND: Clostridium difficile infection (CDI) is the leading cause of infectious nosocomial diarrhoea in Europe. Despite increased focus, its incidence and severity are increasing in many European countries. AIM: We developed a series of consensus statements to identify unmet clinical needs in the recognition and management of CDI. METHODS: A consortium of European experts prepared a series of 29 statements representing their collective views on the diagnosis and management of CDI in Europe. The statements were grouped into the following six broad themes: diagnosis; definitions of severity; treatment failure, recurrence and its consequences; infection prevention and control interventions; education and antimicrobial stewardship; and National CDI clinical guidance and policy. These statements were reviewed using questionnaires by 1047 clinicians involved in managing CDI, who indicated their level of agreement with each statement. FINDINGS: Levels of agreement exceeded the 66% threshold for consensus for 27 out of 29 statements (93.1%), indicating strong support. Variance between countries and specialties was analysed and showed strong alignment with the overall consensus scores. CONCLUSION: Based on the consensus scores of the respondent group, recommendations are suggested for the further development of CDI services in order to reduce transmission and recurrence and to ensure that appropriate diagnosis and treatment strategies are applied across all healthcare settings.
Funding
Astellas Pharma EMEA initiated and fully supported the
consensus project including the selection of the initial faculty
of experts, who were able to cover the broad aspects of
CDI management. Astellas Pharma EMEA paid the expert
group an honorarium and travel expenses. Astellas Pharma
EMEA commissioned Triducive Ltd to facilitate the project
and analyse the responses to the consensus statements, in
line with the Delphi methodology, and supported the authors
in producing the manuscript. Astellas Pharma EMEA
provided editorial assistance for the final manuscript by way
of a factual accuracy check only. H. Seifert reports grants or
research support from the Bundesministerium fu¨r Bildung
und Forschung (BMBF), Germany, the German Center for
Infection Research, Basilea, Novartis and Pfizer; has been a
consultant for Astellas, AstraZeneca, Basilea, Cubist,
Novartis, Pfizer, and The Medicines Company; and has
received payments for lectures from MSD, Novartis, and
Pfizer. A. Stallmach reports honoraria for participating in
scientific advisory boards organized by Astellas. All of his
activities and contracts are in conformity with the ‘FSAKodex
Fachkreise’ (voluntary self-monitoring code for
expert consultants to the pharmaceutical industry), have
been checked by the Medicolegal Department of the University
Hospital Jena, and have been approved by the
directorate of the Faculty of Medicine. S. Goldenberg reports
consulting fees, lecture fees, and research grants from
Astellas. V. Anttila reports research support from MSD,
Pfizer, GSK, and Astellas, consulting fees from MSD, and
lecture fees from MSD, Pfizer, and Astellas. D. Jenkins reports
speaker fees and advisory board fees from Astellas and
is a director of Healthcare Infection Prevention Ltd. T.
Galperine reports advisory board fees from Astellas. N.
Petrosillo reports speaker’s fees from MSD, Novartis, Astellas,
Gilead, Pfizer, advisory board fees from Carefusion,
Johnson & Johnson, Ac
History
Citation
Journal of Hospital Infection, 2015, 90 (2), pp. 117-125
Author affiliation
/Organisation/COLLEGE OF MEDICINE, BIOLOGICAL SCIENCES AND PSYCHOLOGY/School of Medicine/Department of Medical Education