Hostname: page-component-cd9895bd7-gvvz8 Total loading time: 0 Render date: 2024-12-25T15:40:27.306Z Has data issue: false hasContentIssue false

Reducing Clostridium difficile Colitis Rates Via Cost-Saving Diagnostic Stewardship

Published online by Cambridge University Press:  03 April 2018

Christina Yen
Affiliation:
Los Angeles County and University of Southern California Medical Center, Los Angeles, California Department of Medicine, Keck School of Medicine at the University of Southern California, Los Angeles, California
Paul Holtom
Affiliation:
Los Angeles County and University of Southern California Medical Center, Los Angeles, California Department of Medicine, Keck School of Medicine at the University of Southern California, Los Angeles, California
Susan M. Butler-Wu
Affiliation:
Los Angeles County and University of Southern California Medical Center, Los Angeles, California Department of Pathology, Keck School of Medicine at the University of Southern California, Los Angeles, California.
Noah Wald-Dickler
Affiliation:
Los Angeles County and University of Southern California Medical Center, Los Angeles, California Department of Medicine, Keck School of Medicine at the University of Southern California, Los Angeles, California
Ira Shulman
Affiliation:
Los Angeles County and University of Southern California Medical Center, Los Angeles, California Department of Pathology, Keck School of Medicine at the University of Southern California, Los Angeles, California.
Brad Spellberg*
Affiliation:
Los Angeles County and University of Southern California Medical Center, Los Angeles, California Department of Medicine, Keck School of Medicine at the University of Southern California, Los Angeles, California
*
Address correspondence to Brad Spellberg, MD, 2051 Marengo Street, Los Angeles, CA 90033 ([email protected]).

Abstract

We conducted a quality improvement project at a large public tertiary-care academic hospital to reduce reported hospital-acquired Clostridium difficile infection (CDI) rates. We introduced diagnostic stewardship and provider education, resulting in a 2-fold reduction in C. difficile nucleic acid amplification test (NAAT) orders and markedly lower hospital CDI rate.

Infect Control Hosp Epidemiol 2018;39:734–736

Type
Concise Communications
Copyright
© 2018 by The Society for Healthcare Epidemiology of America. All rights reserved 

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

REFERENCES

1. Desai, K, Gupta, SB, Dubberke, ER, Prabhu, VS, Browne, C, Mast, TC. Epidemiological and economic burden of Clostridium difficile in the United States: estimates from a modeling approach. BMC Infect Dis 2016;16:303.Google Scholar
2. Bartlett, JG. Clinical practice. Antibiotic-associated diarrhea. N Engl J Med 2002;346:334339.Google Scholar
3. Bartlett, JG, Gerding, DN. Clinical recognition and diagnosis of Clostridium difficile infection. Clin Infect Dis 2008;46(Suppl 1):S12S18.Google Scholar
4. Katz, DA, Lynch, ME, Littenberg, B. Clinical prediction rules to optimize cytotoxin testing for Clostridium difficile in hospitalized patients with diarrhea. Am J Med 1996;100:487495.CrossRefGoogle ScholarPubMed
5. Gerding, DN, Brazier, JS. Optimal methods for identifying Clostridium difficile infections. Clin Infect Dis 1993;16(Suppl 4):S439S442.CrossRefGoogle ScholarPubMed
6. Brecher, SM, Novak-Weekley, SM, Nagy, E. Laboratory diagnosis of Clostridium difficile infections: there is light at the end of the colon. Clin Infect Dis 2013;57:11751181.Google Scholar
7. Carey, RG, Lloyd, RC. Measuring Quality Improvement in Healthcare. Milwaukee: Quality Press; 2001.Google Scholar
8. Bunnell, KL, Danziger, LH, Johnson, S. Economic barriers in the treatment of Clostridium difficile infection with oral vancomycin. Open Forum Infect Dis 2017;4:ofx078.Google Scholar
9. Fang, FC, Polage, CR, Wilcox, MH. Point-counterpoint: What is the optimal approach for detection of Clostridium difficile infection? J Clin Microbiol 2017;55:670680.CrossRefGoogle ScholarPubMed
10. Burnham, CA, Carroll, KC. Diagnosis of Clostridium difficile infection: an ongoing conundrum for clinicians and for clinical laboratories. Clin Microbiol Rev 2013;26:604630.Google Scholar
Supplementary material: Image

Yen et al. supplementary material

Figure S1

Download Yen et al. supplementary material(Image)
Image 166.3 KB