Hostname: page-component-cd9895bd7-fscjk Total loading time: 0 Render date: 2024-12-26T22:58:58.520Z Has data issue: false hasContentIssue false

Use of diagnostic and antimicrobial stewardship practices to improve Clostridioides difficile testing among SHEA Research Network hospitals

Published online by Cambridge University Press:  11 August 2021

Kaede V. Sullivan*
Affiliation:
Department of Pathology and Laboratory Medicine, Lewis Katz School of Medicine at Temple University; Philadelphia, Pennsylvania
Jason C. Gallagher
Affiliation:
Temple University School of Pharmacy, Philadelphia, Pennsylvania
Surbhi Leekha
Affiliation:
Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland
Daniel J. Morgan
Affiliation:
Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland
Kazumi Morita
Affiliation:
Temple University Hospital, Philadelphia, Pennsylvania
Clare Rock
Affiliation:
Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland
Kimberly C. Claeys
Affiliation:
Department of Pharmacy Practice and Science, University of Maryland School of Pharmacy, Baltimore, Maryland
*
Author for correspondence: Kaede V. Sullivan, E-mail: kaede.ota@tuhs.temple.edu

Abstract

We surveyed acute-care hospitals on strategies to reduce inappropriate C. difficile testing and treatment of colonized patients. Decision support during C. difficile test ordering was common, but “hard stops” to prevent placement of inappropriate orders and active intervention of antimicrobial stewardship programs on positive C. difficile test reports were infrequent.

Type
Concise Communication
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

McDonald, LC, Gerding, DN, Johnson, S, et al. Clinical practice guidelines for Clostridium difficile infection in adults and children: 2017 update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA). Clin Infect Dis 2018;66(7):e1e48.CrossRefGoogle Scholar
Rock, C, Pana, Z, Leekha, S, et al. National Healthcare Safety Network laboratory-identified Clostridium difficile event reporting: a need for diagnostic stewardship. Am J Infect Control 2018;46:456458.CrossRefGoogle ScholarPubMed
Mizusawa, M, Small, BA, Hsu, YJ, et al. Prescriber behavior in Clostridioides difficile testing: a 3-hospital diagnostic stewardship intervention. Clin Infect Dis 2019;69:20192021.CrossRefGoogle ScholarPubMed
Kwon, JH, Reske, KA, Hink, T, Jackups, R, Burnham, CD, Dubberke, ER. Impact of an electronic hard-stop clinical decision support tool to limit repeat Clostridioides difficile toxin enzyme immunoassay testing on test utilization. Infect Control Hosp Epidemiol 2019;40:14231426.CrossRefGoogle ScholarPubMed
White, DR, Hamilton, KW, Pegues, DA, Hanish, A, Umscheid, CA. The impact of a computerized clinical decision support tool on inappropriate Clostridium difficile testing. Infect Control Hosp Epidemiol 2017;38:12041208.CrossRefGoogle ScholarPubMed
Madden, GR, German Mesner, I, Cox, HL, Mathers, AJ, Lyman, JA, Sifri, CD, Reduced, Enfield KB. Clostridium difficile tests and laboratory-identified events with a computerized clinical decision support tool and financial incentive. Infect Control Hosp Epidemiol 2018;39:737740.10.1017/ice.2018.53CrossRefGoogle ScholarPubMed
Pillai, DR. Section 3.8.3: Clostridium difficile toxin detection. In: Amy Leber, ed. Clinical Microbiology Procedures Handbook, 4th ed. Washington, DC: ASM Press, 2016.Google Scholar
Polage, CR, Gyorke, CE, Kennedy, MA, et al. Overdiagnosis of Clostridium difficile infection in the molecular test era. JAMA Intern Med 2015;175:17921801.CrossRefGoogle ScholarPubMed
Guh, AY, Hatfield, KM, Winston, LG, et al. Toxin enzyme immunoassays detect Clostridioides difficile infection with greater severity and higher recurrence rates. Clin Infect Dis 2019;69:16671674.CrossRefGoogle ScholarPubMed
Hecker, MT, Son, AH, Alhmidi, H, Wilson, BM, Wiest, PM, Donskey, CJ. Efficacy of a stewardship intervention focused on reducing unnecessary use of non–Clostridioides difficile antibiotics in patients with Clostridioides difficile infection. Infect Control Hosp Epidemiol 2020;41:216218.Google ScholarPubMed
Supplementary material: File

Sullivan et al. supplementary material

Sullivan et al. supplementary material

Download Sullivan et al. supplementary material(File)
File 48.5 KB