Diagnostic stewardship of Clostridioides difficile polymerase chain reaction results from syndromic diarrhea panel and implications for patient outcomes
Copyright © 2020 Elsevier Inc. All rights reserved..
BACKGROUND: A syndromic gastrointestinal pathogen panel (GIP) was implemented in May 2018. All positive (+) GIP and standard-of-care (SOC) C. difficile results were reviewed.
METHODS: A single-center audit of adult patients with GIP results was conducted May-December 2018. We reviewed GIP(+)/SOC(+/-) and GIP(-)/SOC(-) tests (control group) for clinical outcomes.
RESULTS: We reviewed 269 GIP(+) patients. Of 119 GIP(+)/SOC(+) patients, 44 (37%) were positive by toxin A/B enzyme immunoassay, and 75 (63%) by PCR only. Thirty-day mortality and re-admission were not significantly different between groups. CDI rates within 6 months were not significantly different between GIP(+)/SOC(-) and controls (p-value = 0.39). Those with initial SOC(+) tests had more true CDI events within 6 months, compared to controls (p-values < 0.001).
CONCLUSIONS: Forty percent of patients with GIP(+) C. difficile were (-) by SOC test, suggesting that true CDI was not present. Additional PCR-based testing may not impact outcomes.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:97 |
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| Enthalten in: |
Diagnostic microbiology and infectious disease - 97(2020), 2 vom: 15. Juni, Seite 115032 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Wadskier, Francis [VerfasserIn] |
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| Links: |
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| Themen: |
Clostridiodes difficile infection |
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| Anmerkungen: |
Date Completed 27.11.2020 Date Revised 10.12.2020 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.diagmicrobio.2020.115032 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM308844998 |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2020 Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: A syndromic gastrointestinal pathogen panel (GIP) was implemented in May 2018. All positive (+) GIP and standard-of-care (SOC) C. difficile results were reviewed | ||
| 520 | |a METHODS: A single-center audit of adult patients with GIP results was conducted May-December 2018. We reviewed GIP(+)/SOC(+/-) and GIP(-)/SOC(-) tests (control group) for clinical outcomes | ||
| 520 | |a RESULTS: We reviewed 269 GIP(+) patients. Of 119 GIP(+)/SOC(+) patients, 44 (37%) were positive by toxin A/B enzyme immunoassay, and 75 (63%) by PCR only. Thirty-day mortality and re-admission were not significantly different between groups. CDI rates within 6 months were not significantly different between GIP(+)/SOC(-) and controls (p-value = 0.39). Those with initial SOC(+) tests had more true CDI events within 6 months, compared to controls (p-values < 0.001) | ||
| 520 | |a CONCLUSIONS: Forty percent of patients with GIP(+) C. difficile were (-) by SOC test, suggesting that true CDI was not present. Additional PCR-based testing may not impact outcomes | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Clostridiodes difficile infection | |
| 650 | 4 | |a diagnostic stewardship | |
| 650 | 4 | |a gastrointestinal pathogen panel | |
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| 700 | 1 | |a Szymczak, Wendy A |e verfasserin |4 aut | |
| 700 | 1 | |a Weston, Greg |e verfasserin |4 aut | |
| 700 | 1 | |a Guo, Yi |e verfasserin |4 aut | |
| 700 | 1 | |a Bartash, Rachel |e verfasserin |4 aut | |
| 700 | 1 | |a Levi, Michael H |e verfasserin |4 aut | |
| 700 | 1 | |a Nori, Priya |e verfasserin |4 aut | |
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