Misdiagnosis of Clostridioides difficile Infections by Standard-of-Care Specimen Collection and Testing among Hospitalized Adults, Louisville, Kentucky, USA, 2019–20201

Details

• Alternative Title:
  Emerg Infect Dis
• Personal Author:
  Ramirez, Julio A. ; Angulo, Frederick J. ; Carrico, Ruth M. ; Furmanek, Stephen ; Oliva, Senén Peña ; Zamparo, Joann M. ; Gonzalez, Elisa ; Zhang, Pingping ; Parrish, Leslie A. Wolf ; Marimuthu, Subathra ; Pride, Michael W. ; Gray, Sharon ; Matos Ferreira, Cátia S. ; Arnold, Forest W. ; Istúriz, Raul E. ; Minarovic, Nadia ; Moïsi, Jennifer C. ; Jodar, Luis
• Description:
  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, Kentucky, USA, during October 14, 2019-October 13, 2020; concurrent SOC stool collection and CDI testing occurred independently. A study CDI case was nucleic acid amplification test‒/cytotoxicity neutralization assay‒positive or nucleic acid amplification test‒positive stool in a patient with pseudomembranous colitis. Study incidence was adjusted for hospitalization share and specimen collection rate and, in a sensitivity analysis, for diarrhea cases without study testing. SOC hospitalized CDI incidence was 121/100,000 population/year; study incidence was 154/100,000 population/year and, in sensitivity analysis, 202/100,000 population/year. Of 75 SOC CDI cases, 12 (16.0%) were not study diagnosed; of 109 study CDI cases, 44 (40.4%) were not SOC diagnosed. CDI incidence estimates based on SOC CDI testing are probably underestimated.
• Subjects:
  Adult Bacteria Clinical Laboratory Techniques Clostridioides Difficile Clostridium Infections Diagnosis Diagnostic Errors Diarrhea Epidemiology Hospitalization Hospitalized Adults Humans Infections Kentucky Misdiagnosis Misdiagnosis Of Clostridioides Difficile Infections By Standard-of-Care Specimen Collection And Testing Among Hospitalized Adults, Louisville, Kentucky, USA, 2019–2020 Public Health Surveillance Research Specimen Handling Standard-of-care Specimen Collection Testing United States

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• Source:
  Emerg Infect Dis. 2023; 29(5):919-928
• Pubmed ID:
  37080953
• Pubmed Central ID:
  PMC10124648
• Document Type:
  Journal Article
• Volume:
  29
• Issue:
  5
• Collection(s):
  Emerging Infectious Diseases
• Main Document Checksum:
  urn:sha256:5054d4bb2a79a6bcfceb32f2104ca1b29609302f457d374510b7345c2c0a0645
• Download URL:
  https://stacks.cdc.gov/view/cdc/129105/cdc_129105_DS1.pdf
• File Type:
  [PDF - 892.72 KB ]