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24 INFECTION CONTROL & PATIENT SAFETY Nonventilator hospital- acquired pneumonia is an 'underappreciated' patient safety issue By Anuja Vaidya A study published in American Journal of Infection Control examined the incidence of nonventilator hospi- tal-acquired pneumonia in the U.S. Researchers used the 2012 U.S. National In- patient Sample dataset to compare a group of nonventilator hospital-acquired pneumo- nia patients to four other groups: pneumonia on admission; general hospital admissions; matched on mortality and disease severity; and ventilator-associated pneumonia. The study shows the overall incidence of nonventilator hospital-acquired pneumonia was 1.6 percent, representing a rate of 3.63 per 1,000 patient-days. Researchers also found nonventilator hospi- tal-acquired pneumonia was linked to high- er total hospital charges, longer lengths of stay and greater likelihood of death when compared to all groups except the ventila- tor-associated pneumonia group. "Nonventilator hospital-acquired pneu- monia is an underappreciated and serious patient safety issue, resulting in significant increases in cost, length of stay, and mortali- ty," the study authors concluded. n Researchers assess the most cost- effective C. diff treatments By Brian Zimmerman A s Clostridium difficile creates a significant economic and mor- bidity burden for hospitals, researchers with Cleveland Clinic and the University of Texas School of Public Health in Houston sought to determine the most cost-effective treatment for the illness in a study published Feb. 21 in the journal Infection Control & Hospital Epidemiology. For the study, researchers reviewed 14 previous C. diff studies conduct- ed prior to August 2016. Elements of C. diff examined in the study in- cluded treatment cost, cure rates and infection recurrence rates, among other influential treatment cost factors. Here are four study findings. 1. Fidaxomicin, a newer treatment for C. diff, was often the most cost-ef- fective treatment, though the findings were not definitive, as results from the individual studies largely varied based on the nature of the infection. 2. For initial C. diff, treatment with fidaxomicin was more cost-effective than vancomycin or metronidazole in 2 of 3 studies. 3. For more severe initial C. diff, fidaxomicin was the most cost-effec- tive in two of three studies. For recurrent C. diff infections, fidaxomicin proved most cost-effective in three of five studies. 4. However, researchers found fecal microbiota transplantation via colo- noscopy to be most cost-effective in treating recurrent C. diff in four out of four studies. "The cost-effectiveness of fidaxomicin compared with other pharmaco- logic therapies was not definitive for either initial or recurrent [C. diff]," wrote the study's authors. "Despite its high cost, FMT by colonoscopy may be a cost-effective therapy for recurrent [C. diff]. A consensus on model design and assumptions are necessary for future comparison of [C. diff] treatment." n Study: Certain types of gut bacteria could aid creation of new sepsis treatments By Brian Zimmerman C ertain gut microbes may help researchers develop a new treatment for sepsis, suggest study findings published in the journal Cell Host & Microbe. For the study, researchers exposed mice to unique microflora found in the guts of mice and humans known to produce antibodies that can help block bacterial infections. Exposure resulted in higher levels of the immunoglobulin A antibodies in the blood. Mice with these enriched levels of antibodies in their blood survived longer aer being exposed to sepsis compared to mice without heightened levels of these antibodies. The study authors said specific properties of the antibodies could aid in the develop- ment of new sepsis treatments. However, researchers urged caution in interpretation of the findings. "e study is limited by the fact that the microbiome in every person or animal is unique to some degree, and our study is in the context of the animal facility," said David Allman, PhD, of the Perelman School of Medicine at the University of Pennsylvania in Philadelphia. "While IgA protected mice in our study, it should not be assumed that IgA could replace standard treatments pro- vided to patients in a clinical setting." n