Clostridium difficile colonization among patients with clinically significant diarrhea and no identifiable cause of diarrhea

Details

• Alternative Title:
  Infect Control Hosp Epidemiol
• Personal Author:
  Dubberke, Erik R. ; Reske, Kimberly A. ; Hink, Tiffany ; Kwon, Jennie H. ; Cass, Candice ; Bongu, Jahnavi ; Burnham, Carey-Ann D. ; Henderson, Jeffrey P.
• 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%.
  
  
• Subjects:
  Bacterial Toxins Clostridioides Difficile Clostridium Infections Diarrhea Enterotoxins Feces Humans Immunoenzyme Techniques Laboratories, Hospital Prevalence Retrospective Studies

  More +
• Source:
  Infect Control Hosp Epidemiol. 39(11):1330-1333
• Pubmed ID:
  30226126
• Pubmed Central ID:
  PMC6890223
• Document Type:
  Journal Article
• Funding:
  U01 AI025903/AI/NIAID NIH HHSUnited States/ ; U54 CK000609/CK/NCEZID CDC HHSUnited States/ ; UL1 TR002345/TR/NCATS NIH HHSUnited States/ ; KL2 TR000450/TR/NCATS NIH HHSUnited States/ ; KL2 TR002346/TR/NCATS NIH HHSUnited States/ ; UL1 TR000448/TR/NCATS NIH HHSUnited States/
• Place as Subject:
  Missouri
• Volume:
  39
• Issue:
  11
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:5d5270cec23b787bde202930126b1e2a14e6018e6cc70bef9acbd704ef4aae89
• Download URL:
  https://stacks.cdc.gov/view/cdc/114224/cdc_114224_DS1.pdf
• File Type:
  [PDF - 230.69 KB ]