An infectious disease-led C. difficile testing approval process was feasible and associated with a 50% decrease in HO-CDI rates, due to enforcement of appropriate testing.

Introduction. Environmental surveillance for Clostridioides difficile is challenging. There are no internationally agreed recommendations on which method should be used when environmental surveillance is undertaken. Aim. To compare the detection of C. difficile by RT-PCR to culture-based methods and to determine which is more sensitive and specific in the clinical environment. Methods. Forty-four near-patient areas of C. difficile -positive patients were sampled using contact plates and moistened flocked swabs. Results. Detection using moistened flocked swabs followed by RT-PCR or culture detected more C. difficile than contact plates. The sensitivity and specificity of a RT-PCR assay for tcdB compared to the culture methods was 76 and 91 %, respectively. Conclusion. Despite the lower sensitivity and specificity, RT-PCR could potentially offer a more rapid and practical alternative.

Joseph Reilly, BS, PharmD, BCGP; Candace Cotto, RN; and Andrew Skinner, MD, review C. difficile infection (CDI), its risk factors, symptoms, and quality of life for the patient.

A stringent order-approval process reduced clinically nonindicated testing for C. difficile but did not significantly decrease HAIs.

A stringent order-approval process reduced clinically nonindicated testing for C. difficile but did not significantly decrease HAIs.

Use of an algorithm defining criteria for C. difficile testing, diagnosis, and treatment was associated with significantly decreased CDI diagnoses on a HSCT inpatient unit without apparent adverse effects.

Although Clostridioides difficile infection (CDI) incidence is high in the United States, standard-of-care (SOC) stool collection and testing practices might result in incidence overestimation or underestimation. We conducted diarrhea surveillance among inpatients 50 years of age in Louisville, …

A-two-step-algorithm-for-Clostridioides-difficile-infection-CDI-testing-may-reduce-unnecessary-treatment-and-improve-detection-according-to-data-presented-at

Excellent presentation @kerrieanndavies @ESCMID #ECCMID23 #ECCMID2023 lactoferrin may help tease out the significance of GDH positive /EIA negative #cdiff samples - 40min turn around - quantitative version pic.twitter.com/6J05b12NEN— Prof. Fidelma Fitzpatrick (@FfitzP) April 18, 2023

Misdiagnosis of Clostridioides difficile Infections

So proud of our former ID PGY2 (and 🦸‍♀️super steward) @LinezoLiv who just presented one of her residency projects here at #ECCMID2023 finding a two-step method for C diff testing led to a reduction in unnecessary treatment 🙌 #Cdiff #DiagnosticStewardship #IDtwitter pic.twitter.com/9eUH3iOS34— Bug Pharmacist 💊🧫 Tim Gauthier (@IDstewardship) April 15, 2023

null

The global Clostridium Diagnostics Market is anticipated to grow at a 12.2% CAGR from 2022 to 2032, from US$ 2.5 billion to US$ 7.8 billion. The market saw a 13.6% CAGR between 2015 and 2021. The market is expanding as a result of increased awareness-raising activities for clostridium-related ill...

The global Clostridium Diagnostics Market is anticipated to grow at a 12.2% CAGR from 2022 to 2032, from US$ 2.5 billion to US$ 7.8 billion. The market saw a 13.6% CAGR between 2015 and 2021. The market is expanding as a result of increased awareness-raising activities for clostridium-related illnesses and their rising prevalence. There has been an increased focus of […]

Neither PCT nor CRP helped discriminate bacterial colitis from nonbacterial colitis.

Among 1660 cases with only PCR data, the cycle threshold was significantly associated with recurrence-free survival.

VisualDx is a platform that can provide clinicians with assistive technology and burgeoning providers with patient education.

The laboratory diagnosis of Clostridioides difficile infection (CDI) is challenging since this bacteria may be detected in healthy people and toxin production detection is not sensitive enough to be used alone. Thus, there is no single test with adequate sensitivity and specificity to be used in lab …

The results are meaningful and offer a practicable pipeline for a national-wide surveillance of C. difficile in China.

Children with acute gastrointestinal infections experience substantial variation in stool testing within and across hospitals, with no difference in utilization outcomes. These findings highlight the need for guidelines to address diagnostic stewardship.

A nucleic acid amplification test (NAAT) is recommended to determine whether or not patients have a Clostridioides difficile infection (CDI) when the glutamate dehydrogenase activity assay is positive and the rapid membrane enzyme immunoassays for toxins is negative. In our hospital, a NAAT w …

Our intervention successfully reduced inappropriate stool testing within a large safety-net hospital system.

Misdiagnosis of Clostridioides difficile Infections

We describe the implementation of an electronic medical record "hard stop" to decrease inappropriate Clostridioides difficile testing across a 5-hospital health system, effectively reducing the rates of healthcare-facility-onset C. difficile infection. This novel approach included expe …

Background Healthcare-associated infections (HAIs) are a threat to patients. Accurate surveillance is required to identify and prevent HAIs. To estimate the incidence rate, report the accuracy and identify the barriers of reporting HAIs using a mixed-method study. Methods In this quantitative study, we externally evaluated the incidence rate and accuracy of the routine surveillance system in one of the main hospitals by an active follow-up of patients from September to December 2021. We used in-depth interviews with 18 experts to identify the barriers of the routine surveillance system. Results Among 404 hospitalized patients, 88 HAIs were detected. The estimated rate of HAIs was 17.1 (95% Confidence Intervals 95: 14.1, 21.1) per 1000 patient-days follow-up. However, in the same period, 116 HAIs were reported by the routine surveillance system, but the agreement between the two approaches was low (sensitivity = 61.4%, specificity = 82.6%, negative predictive value = 89.7%, and positive predictive validity = 46.5%). The minimum and maximum positive predictive values were observed in urinary tract infection (32.3%) and surgical site infection (60.9%). The main barrier of reporting HAIs was lack of cooperation in reporting HAIs by infection control link nurses and laboratory supervisors. Conclusions The discrepancy between the longitudinal study findings and the routine surveillance might be related to the inaccessibility of the surveillance system to clinical information of patients. In this regard, decreasing the barriers, increasing the knowledge of infection control nurses and other nurses, as well as the development of hospital information systems are necessary.

Are you having trouble getting your hospitals to run C diff testing on patients? Running into issues here with admin citing CMS guidelines saying they will only test if fever, significant leukocytosis, etc.#GITwitter #IDTwitter @GI_Pearls @DrHarryThomas @PerelmansPearls #Cdiff— Naveen Reddy (@DrReddyGI) March 21, 2023

The results suggest that disk diffusion can be an interesting routine tool to identify erythromycin- and rifampicin-resistant C. difficile isolates (≥20 mm cut-off) and wild type (WT) strains (≥28 mm). However, the disk diffusion protocol tested in this study does not seem suitable for tetracycline …

Southern Ohio Medical Center worked with MEDITECH Professional Services to create a process to differentiate between active C. diff infections and colonization.