Differences in time-to-testing and time-to-isolation between community-onset and hospital-onset Clostridioides difficile cases at a tertiary care VA medical center - 22/09/20
, J. Bradford Bertumen, MD a, b, Lawrence P. Park, PhD a, b, Susan B. Wilkins, BS, MDiv a, Christopher W. Woods, MD, MPH a, bHighlights |
• | Testing for CDI is commonly delayed among hospital-onset patients |
• | Hospital-onset CDI patients are less likely to be isolated empirically |
• | A minority of CDI patients are placed on empiric isolation prior to testing |
Résumé |
Background |
Delayed identification and isolation of patients with Clostridiodies difficile infection (CDI) may contribute to in-hospital transmission and delay appropriate therapy. To assess potential points for intervention, we conducted a retrospective cohort study to determine differences in time-to-testing and time-to-isolation among community-onset (CO), community-onset healthcare facility-associated (CO-HCFA), and hospital-onset (HO) CDI.
Methods |
We compared clinical and demographic data of all CO, CO-HCFA, and HO CDI patients at our institution between October 2011 and September 2015. We then performed bivariable analysis on our cohorts to identify differences in time-to-testing and time-to-isolation for CO versus CO-HCFA versus HO CDI patients.
Results |
355 patients with CDI were hospitalized during the study; 138 (38.9%) with CO CDI, 52 (14.6%) with CO-HCFA CDI, and 165 (46.5%) with HO CDI. 117 (84.8%) CO CDI patients were tested within 1 day of diarrhea onset compared to 41 (78.8%) of CO-HCFA and 113 (68.5%) of HO CDI patients (P < .01). 51 CO CDI patients (36.7%) were placed on empirical isolation precautions at the time of diarrhea onset compared to 22 (43.1%) of CO-HCFA CDI patients and 32 (19.4%) of HO CDI patients (P < .01).
Conclusions |
CO CDI patients are more likely to be isolated empirically and tested earlier than HO CDI patients. Further attention should be paid to isolating hospitalized patients who develop diarrhea as an inpatient.
Le texte complet de cet article est disponible en PDF.Key Words : CDI, Diarrhea, Isolation
Plan
| Preliminary data from this work was presented in the Clostridium difficile: Outcomes, Testing, Prevention poster session during IDWeek 2016. |
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| Financial Support: None |
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| Conflicts of interest: None to report. |
Vol 48 - N° 10
P. 1148-1151 - octobre 2020 Retour au numéro
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