Diagnostic stewardship of C. difficile testing: a quasi-experimental antimicrobial stewardship study

Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America
Alyssa B ChristensenNathaniel J Rhodes

Abstract

We evaluated whether a diagnostic stewardship initiative consisting of ASP preauthorization paired with education could reduce false-positive hospital-onset (HO) Clostridioides difficile infection (CDI). Single center, quasi-experimental study. Tertiary academic medical center in Chicago, Illinois. Adult inpatients were included in the intervention if they were admitted between October 1, 2016, and April 30, 2018, and were eligible for C. difficile preauthorization review. Patients admitted to the stem cell transplant (SCT) unit were not included in the intervention and were therefore considered a contemporaneous noninterventional control group. The intervention consisted of requiring prescriber attestation that diarrhea has met CDI clinical criteria, ASP preauthorization, and verbal clinician feedback. Data were compared 33 months before and 19 months after implementation. Facility-wide HO-CDI incidence rates (IR) per 10,000 patient days (PD) and standardized infection ratios (SIR) were extracted from hospital infection prevention reports. During the entire 52 month period, the mean facility-wide HO-CDI-IR was 7.8 per 10,000 PD and the SIR was 0.9 overall. The mean ± SD HO-CDI-IR (8.5 ± 2.0 vs 6.5 ± 2.3; P < .001) and SIR (...Continue Reading

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Citations

Dec 21, 2019·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Alessandra B Garcia ReevesMorris Weinberger
Jun 4, 2020·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Nikki N TranGregory A Eschenauer
Oct 2, 2020·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Alessandra B Garcia ReevesMorris Weinberger
Sep 19, 2020·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Dipesh SolankyMonika Kumaraswamy
Nov 3, 2020·Open Forum Infectious Diseases·Kayla R StoverChristopher M Bland
Mar 26, 2021·Current Infectious Disease Reports·Frances J BolyJennie H Kwon
Mar 27, 2021·Infectious Diseases and Therapy·Helen S LeeJennifer Le
Apr 21, 2021·Antimicrobial Agents and Chemotherapy·Nathaniel J RhodesTeresa R Zembower
Jul 8, 2021·Current Opinion in Infectious Diseases·Larry K KociolekHayden T Schwenk
Nov 19, 2021·Journal of the Pediatric Infectious Diseases Society·Hayden T SchwenkAna M Vaughan-Malloy
Dec 22, 2019·American Journal of Infection Control·Jonathan BaghdadiShelly S de Peralta

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Antimicrobial Resistance (ASM)

Antimicrobial resistance poses a significant threat to the continued successful use of antimicrobial agents for the treatment of bacterial infections.

Antimicrobial Resistance

Antimicrobial resistance poses a significant threat to the continued successful use of antimicrobial agents for the treatment of bacterial infections.