학술논문
Misdiagnosis of Clostridioides difficile Infections by Standardof- Care Specimen Collection and Testing among Hospitalized Adults, Louisville, Kentucky, USA, 2019–20201.
Document Type
Article
Author
Ramirez, Julio A.; Angulo, Frederick J.; Carrico, Ruth M.; Furmanek, Stephen; Oliva, Senén Peña; Zamparo, Joann M.; Gonzalez, Elisa; Zhang, Pingping; Wolf Parrish, Leslie A.; Marimuthu, Subathra; Pride, Michael W.; Gray, Sharon; Matos Ferreira, Cátia S.; Arnold, Forest W.; Istúriz, Raul E.; Minarovic, Nadia; Moïsi, Jennifer C.; Jodar, Luis
Source
Subject
*CLOSTRIDIOIDES difficile
*DIAGNOSTIC errors
*ADULTS
*NUCLEIC acids
*COLLECTIONS
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Language
ISSN
1080-6040
Abstract
Although Clostridioides difficile infection (CDI) incidence is high in the United States, standard-of-care (SOC) stool collection and testing practices might result in incidence overestimation or underestimation. We conducted diarrhea surveillance among inpatients >50 years of age in Louisville, Kentucky, USA, during October 14, 2019–October 13, 2020; concurrent SOC stool collection and CDI testing occurred independently. A study CDI case was nucleic acid amplification test‒/cytotoxicity neutralization assay‒positive or nucleic acid amplification test‒positive stool in a patient with pseudomembranous colitis. Study incidence was adjusted for hospitalization share and specimen collection rate and, in a sensitivity analysis, for diarrhea cases without study testing. SOC hospitalized CDI incidence was 121/100,000 population/year; study incidence was 154/100,000 population/ year and, in sensitivity analysis, 202/100,000 population/ year. Of 75 SOC CDI cases, 12 (16.0%) were not study diagnosed; of 109 study CDI cases, 44 (40.4%) were not SOC diagnosed. CDI incidence estimates based on SOC CDI testing are probably underestimated. [ABSTRACT FROM AUTHOR]