Hostname: page-component-8448b6f56d-gtxcr Total loading time: 0 Render date: 2024-04-18T18:40:09.452Z Has data issue: false hasContentIssue false
  • English
  • Français

Gut Check: Clostridium difficile Testing and Treatment in the Molecular Testing Era

Published online by Cambridge University Press:  18 December 2014

Whitney R. Buckel ,
Edina Avdic ,
Karen C. Carroll ,
Vidhya Gunaseelan ,
Eric Hadhazy  and
Sara E. Cosgrove
Whitney R. Buckel*
Affiliation:
Intermountain Healthcare, Intermountain Medical Center, Murray, Utah
Edina Avdic
Affiliation:
Johns Hopkins Health System, The Johns Hopkins Hospital, Baltimore, Maryland
Karen C. Carroll
Affiliation:
Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland Division of Medical Microbiology, Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Vidhya Gunaseelan
Affiliation:
Johns Hopkins Health System, The Johns Hopkins Hospital, Baltimore, Maryland
Eric Hadhazy
Affiliation:
Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland
Sara E. Cosgrove
Affiliation:
Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland
*
Address correspondence to Whitney R. Buckel, PharmD, Intermountain Medical Center, 5121 South Cottonwood Street, Murray, UT 84107 (whitney.buckel@imail.org).
Get access Rights & Permissions [Opens in a new window]

Abstract

We evaluated the impact of nursing education and stewardship interventions on Clostridium difficile testing and treatment appropriateness. Diarrhea documentation increased for those with positive tests (45% to 70%); pretreatment laxative use decreased (50% to 19%). Appropriate treatment increased for severe infection (57% to 93%), but all asymptomatically colonized patients were treated.

Infect Control Hosp Epidemiol 2014;00(0): 1–5

Type
Concise Communications
Information
Infection Control & Hospital Epidemiology , Volume 36 , Supplement 2 , February 2015 , pp. 217 - 221
Copyright
© 2014 by The Society for Healthcare Epidemiology of America. All rights reserved 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Presented at IDWeek; San Diego, CA; October 19, 2012.

References

1. Longtin, Y, Trottier, S, Brochu, G, et al. Impact of the type of diagnostic assay on Clostridium difficile infection and complication rates in a mandatory reporting program. Clin Infect Dis 2013;56:67–73.Google Scholar
2. Cohen, SH, Gerding, DN, Johnson, S, et al. Clinical practice guidelines for Clostridium difficile infection in adults: 2010 update by the Society for Healthcare Epidemiology of America (SHEA) and the Infectious Diseases Society of America (IDSA). Infect Control Hosp Epidemiol 2010;31:431–455.Google Scholar
3. Sydnor, ER, Lenhart, A, Trollinger, B, et al. Antimicrobial prescribing practices in response to different Clostridium difficile diagnostic methodologies. Infect Control Hosp Epidemiol 2011;32:1133–1136.Google Scholar
4. Dubberke, ER, Han, Z, Bobo, L, et al. Impact of clinical symptoms on interpretation of diagnostic assays for Clostridium difficile infections. J Clin Microbiol 2011;49:2887–2893.CrossRefGoogle ScholarPubMed
5. Peterson, LR, Manson, RU, Paule, SM, et al. Detection of toxigenic Clostridium difficile in stool samples by real-time polymerase chain reaction for the diagnosis of C. difficile-associated diarrhea. Clin Infect Dis 2007;45:1152–1160.Google Scholar
6. Leekha, S, Aronhalt, KC, Sloan, LM, Patel, R, Orenstein, R. Asymptomatic Clostridium difficile colonization in a tertiary care hospital: admission prevalence and risk factors. Am J Infect Control 2013;41:390–393.CrossRefGoogle Scholar
7. Loo, VG, Bourgault, AM, Poirier, L, et al. Host and pathogen factors for Clostridium difficile infection and colonization. N Engl J Med 2011;365:1693–1703.Google Scholar
8. Alasmari, F, Seiler, SM, Hink, T, et al. Prevalence and risk factors for asymptomatic Clostridium difficile carriage. Clin Infect Dis 2014;59:216–222.Google Scholar
9. Johnson, S, Homann, SR, Bettin, KM, et al. Treatment of asymptomatic clostridium difficile carriers (fecal excretors) with vancomycin or metronidazole. A randomized, placebo-controlled trial. Ann Intern Med 1992;117:297–302.Google Scholar
10. Jardin, CG, Palmer, HR, Shah, DN, et al. Assessment of treatment patterns and patient outcomes before vs after implementation of a severity-based Clostridium difficile infection treatment policy. J Hosp Infect 2013;85:28–32.CrossRefGoogle ScholarPubMed
Supplementary material: PDF

Buckel Supplementary Material

Supplementary Material

Download Buckel Supplementary Material(PDF)
PDF 105.2 KB