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Clostridium difficile colonization among patients with clinically significant diarrhea and no identifiable cause of diarrhea
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11 2018
Source: Infect Control Hosp Epidemiol. 39(11):1330-1333 -
Alternative Title:Infect Control Hosp Epidemiol
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Personal Author:
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Description:Objective:
To determine the prevalence of Clostridium difficile colonization among patients who meet the 2017 IDSA/SHEA C. difficile infection (CDI) Clinical Guideline Update criteria for the preferred patient population for C. difficile testing.
Design:
Retrospective cohort.
Setting:
Tertiary-care hospital in St. Louis, Missouri.
Patients:
Patients whose diarrheal stool samples were submitted to the hospital’s clinical microbiology laboratory for C. difficile testing (toxin EIA) from August 2014 to September 2016.
Interventions:
Electronic and manual chart review were used to determine whether patients tested for C. difficile toxin had clinically significant diarrhea and/or any alternate cause for diarrhea. Toxigenic C. difficile culture was performed on all stool specimens from patients with clinically significant diarrhea and no known alternate cause for their diarrhea.
Results:
A total of 8,931 patients with stool specimens submitted were evaluated: 570 stool specimens were EIA positive (+) and 8,361 stool specimens were EIA negative ( − ). Among the EIA + stool specimens, 107 (19% of total) were deemed eligible for culture. Among the EIA − stool specimens, 515 (6%) were eligible for culture. One EIA + stool specimen (1%) was toxigenic culture negative. Among the EIA − stool specimens that underwent culture, toxigenic C. difficile was isolated from 63 (12%).
Conclusions:
Most patients tested for C. difficile do not have clinically significant diarrhea and/or potential alternate causes for diarrhea. The prevalence of toxigenic C. difficile colonization among EIA − patients who met the IDSA/SHEA CDI guideline criteria for preferred patient population for C. difficile testing was 12%.
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Subjects:
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Pubmed ID:30226126
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Pubmed Central ID:PMC6890223
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