Automated system to identify Clostridium difficile infection among hospitalised patients

Yadav, Yashoo; Garey, Kevin W.; Dao-Tran, T. K.; Kaila, Vishal; Gbito, Kplola Y. Elhor; DuPont, Herbert L.

doi:10.1016/j.jhin.2009.04.017

Cited by 2 publications

(1 citation statement)

References 19 publications

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“…These tests are more sensitive for C. difficile in toxinsamples, but may be less specific for CDI (Wilcox et al 2010; Dubberke et al 2011; Kufelnicka and Kirn 2011). For example, if 20% of hospitalized patients are colonized with C. difficile (Viscidi et al 1981; McFarland et al 1989; Samore et al 1994; Kyne et al 2000; Cohen et al 2010) and most nosocomial diarrhea is unrelated to CDI (McFarland 1995); Bartlett 2002; Garey et al 2006; Yadav et al 2009), it seems likely that some patients with diarrhea and C. difficile are carriers with diarrhea due to other causes (Wilcox et al 2010; Kufelnicka and Kirn 2011). Thus, toxin tests may miss occasional patients with CDI while direct tests for C. difficile may result in overdiagnosis and overtreatment.…”

Section: Introductionmentioning

confidence: 99%

Outcomes in patients tested for Clostridium difficile toxins

Polage

Chin

Leslie

et al. 2012

Diagnostic Microbiology and Infectious Disease

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Clostridium difficile testing is shifting from toxin detection to C. difficile detection. Yet, up to 60% of patients with C. difficile by culture test negative for toxins and it is unclear if they are infected or carriers. We reviewed medical records for 7,046 inpatients with a C. difficile toxin test from 2005–2009 to determine the duration of diarrhea and rate of complications and mortality among toxin-positive (toxin+) and toxin− patients. Overall, toxin− patients had less severe diarrhea, fewer diarrhea days and lower mortality (P<0.001, all comparisons) than toxin+ patients. One toxin− patient (n=1/6,121; 0.02%) was diagnosed with pseudomembranous colitis but there were no complications such as megacolon or colectomy for fulminant CDI among toxin− patients. These data suggest that C. difficile-attributable complications are rare among patients testing negative for C. difficile toxins and more studies are needed to evaluate the clinical significance of C. difficile detection in toxin− patients.

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Section: Introductionmentioning

confidence: 99%

Outcomes in patients tested for Clostridium difficile toxins

Polage

Chin

Leslie

et al. 2012

Diagnostic Microbiology and Infectious Disease

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Predictors of Hospital-Acquired Clostridioides difficile Infection: A Systematic Review

et al. 2019

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Background: Clostridioides difficile infections (CDIs) have been identified as a major health concern due to the high morbidity, mortality, and cost of treatment. The aim of this study was to review the extant literature and identify the various patient-related, medication-related, and organizational risk factors associated with developing hospital-acquired CDIs in adult patients in the United States. Methods: A systematic review of four (4) online databases, including Scopus, PubMed, CINAHL, and Cochrane Library, was conducted to identify empirical studies published from 2007 to 2017 pertaining to risk factors of developing hospital-acquired CDIs. Findings: Thirty-eight studies (38) were included in the review. Various patient-level and medication-related risk factors were identified including advanced patient age, comorbidities, length of hospital stay, previous hospitalizations, use of probiotic medications and proton pump inhibitors. The review also identified organizational factors such as room size, academic affiliation, and geographic location to be significantly associated with hospital-acquired CDIs. Conclusion: Validation of the factors associated with high risk of developing hospital-acquired CDIs identified in this review can aid in the development of risk prediction models to identify patients who are at a higher risk of developing CDIs and developing quality improvement interventions that might improve patient outcomes by minimizing risk of infection.

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Automated system to identify Clostridium difficile infection among hospitalised patients

Cited by 2 publications

References 19 publications

Outcomes in patients tested for Clostridium difficile toxins

Outcomes in patients tested for Clostridium difficile toxins

Predictors of Hospital-Acquired Clostridioides difficile Infection: A Systematic Review

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