C Diff Diagnosis

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.

The test order rate per 1,000 patient-days fell from 126.5 in the pre-intervention period to 90.6 in the intervention period, a 28% reduction.

Institutions with active BMT units should consider implementing ADI.

According to Prophecy Market Insights Hospital Acquired Disease Testing Market accounted for US 7 2 billion in 2020 and is estimated to be US 14 91 billion by 2030 and is anticipated to register a CAGR of 7 6 The ...

This clinical prediction rule for identifying toxigenic C. difficile carriage at admission may facilitate the selective screening of high-risk groups. To implement it in a clinical setting, more patients from other medical institutions need to be prospectively examined.

Clostridioides difficile (C. difficile) is an important nosocomial infection that is commonly associated with antibiotic use with pseudomembranous colitis being present in only 13% of cases. Disease severity ranges from asymptomatic carriers to severe complicated disease, based on clin …

Clostridioides difficile (C. difficile) is an important nosocomial infection that is commonly associated with antibiotic use with pseudomembranous colitis being present in only 13% of cases. Disease severity ranges from asymptomatic carriers to severe complicated disease, based on clin …

This article focuses on the diagnosis and treatment of C. difficile infection and includes an updated summary of literature on the latest guidelines (Part 2).

Testing stool samples for C difficile exotoxins A and B is frequently used to diagnose a C difficile infection, but clinicians need a greater understanding of what the results mean.

Clostridioides difficile (C. difficile) is an important nosocomial infection that is commonly associated with antibiotic use with pseudomembranous colitis being present in only 13% of cases. Dis...

Using a large heterogeneous population of patients, we developed and validated a prediction model that estimates risk for complications from CDI with good accuracy. Future studies should aim to reduce the disparity in model accuracy between White and non-White patients and to improve performance ove …

The clinical outcomes of LOS, MDRO, and CDI were reduced. The phenotypic RDT demonstrated an improvement in stewardship measures and clinical outcomes.

Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening condition that often goes underdiagnosed because of broad and non-specific symptomatology, usually consisting of fever, hepatosplenomegaly, and multiorgan failure. This disorder can be driven by genetic components (primary) or acquired ( …

A 59-year-old man, previously submitted to anterior resection due to rectal cancer, underwent a contrast-enhanced computed tomography (ce-CT) for restaging before eventual chemotherapy. Because ce-CT showed a moderate enlargement of the descending colonic lumen, in despite the lack of symptoms, posi …

The new polymerase chain reaction method was evaluated for specificity, sensitivity, and repeatability using 69 C difficile isolates and 74 fecal samples.

Researchers determined independent predictors for hospital-acquired Clostridioides difficile infection in pediatric patients with antibiotic-associated diarrhea.

We found a correlation between changing the type of test and the way the results were displayed, and reduction in CDI-specific antibiotic use without restricting clinician diagnostic ordering. This strategy may warrant consideration in other conditions where antibiotics are overprescribed, such as u …

Differential costs for testing and practicalities of scaling up testing mean every country needs to consider, balancing CDI testing costs against costs of treatment and care of CDI patients.

Implementing rapid near patient testing (NPT) reduced patient isolation time, length of hospital stay, antibiotic usage, and overall cost.

During the 4 years after implementation of the 2-step Clostridioides difficile infection (CDI) testing algorithm, 70% to 78% of patients with suspected CDI and a positive nucleic acid amplification test but a negative toxin test (NAAT+/TOX-) received CDI treatment. Overall, 73% of NAAT+/TOX- …

The results also show a decrease in antibiotic use, hospital length of stay, and overall cost to the patient.