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Misdiagnosis of Clostridioides difficile Infections by Standard-of-Care Specimen Collection and Testing among Hospitalized Adults, Louisville, Kentucky, USA, 2019-20201.

Created on 21 Apr 2023

Authors

Julio A Ramirez, Frederick J Angulo, Ruth M Carrico, Stephen Furmanek, Senén Peña Oliva, Joann M Zamparo, Elisa Gonzalez, Pingping Zhang, Leslie A Wolf Parrish, Subathra Marimuthu, Michael W Pride, Sharon Gray, Cátia S Matos Ferreira, Forest W Arnold, Raul E Istúriz, Nadia Minarovic, Jennifer C Moïsi, Luis Jodar

Published in

Emerging infectious diseases. Volume 29. Issue 5. Pages 919-928.

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.

PMID:
37080953
Bibliographic data and abstract were imported from PubMed on 21 Apr 2023.

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