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Volume 18, Number 3—March 2012

CME ACTIVITY

Community-associated Clostridium difficile Infections, Monroe County, New York, USA

Earning CME Credit

To obtain credit, you should first read the journal article. After reading the article, you should be able to answer the following, related, multiple-choice questions. To complete the questions (with a minimum 70% passing score) and earn continuing medical education (CME) credit, please go to www.medscape.org/journal/eid. Credit cannot be obtained for tests completed on paper, although you may use the worksheet below to keep a record of your answers. You must be a registered user on Medscape.org. If you are not registered on Medscape.org, please click on the New Users: Free Registration link on the left hand side of the website to register. Only one answer is correct for each question. Once you successfully answer all post-test questions you will be able to view and/or print your certificate. For questions regarding the content of this activity, contact the accredited provider, CME@medscape.net. For technical assistance, contact CME@webmd.net. American Medical Association’s Physician’s Recognition Award (AMA PRA) credits are accepted in the US as evidence of participation in CME activities. For further information on this award, please refer to http://www.ama-assn.org/ama/pub/category/2922.html. The AMA has determined that physicians not licensed in the US who participate in this CME activity are eligible for AMA PRA Category 1 Credits™. Through agreements that the AMA has made with agencies in some countries, AMA PRA credit may be acceptable as evidence of participation in CME activities. If you are not licensed in the US, please complete the questions online, print the certificate and present it to your national medical association for review.

Article Title: Community-associated Clostridium difficile Infections, Monroe County, New York, USA

CME Questions

1. On the basis of the study by Dumyati and colleagues, which of the following statements about the relative burden of and potential risk factors for community-associated (CA) Clostridium difficile infection (CDI) disease is most likely correct?

A. CA-CDI accounted for about half of CDI cases in Monroe County, New York, in 2008

B. The proportion of CA-CDI in this study was much higher than that reported in other recent surveillance studies

C. About three quarters of patients with CA-CDI had taken antibiotics in the 12 weeks before diagnosis

D. About half of patients with CA-CDI reported proton pump inhibitor use

2. On the basis of the study by Dumyati and colleagues, which of the following statements about clinical characteristics of patients with CA disease is most likely correct?

A. About one fifth of the hospitalized CA patients died or had serious complications

B. In addition to diarrhea, 86% reported abdominal pain, 48% nausea, 40% fever, and 17% bloody stool

C. CA-CDI patients were older than HA-CDI patients

D. Molecular testing showed significantly different distribution of strains between HA-CDI and CA-CDI

3. You are a public health official asked to consult on strategies for CA-CDI prevention and surveillance. On the basis of the review by Dumyati and colleagues, which of the following statements would most likely appear in your report?

A. Reducing exposure to specific foods and animals is a viable strategy

B. Outpatient clinicians should be educated about the risk for CA-CDI following oral antibiotic use and about the need for judicious antibiotic use

C. Risk factors leading to CDI in patients not exposed to antibiotics are well defined

D. C. difficile recovery rate from refrigerated stool swabs is poor

Activity Evaluation

1. The activity supported the learning objectives.

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2. The material was organized clearly for learning to occur.

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3. The content learned from this activity will impact my practice.

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4. The activity was presented objectively and free of commercial bias.

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