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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.

Publication ,  Journal Article
Hostler, CJ; Bertumen, JB; Park, LP; Wilkins, SB; Woods, CW
Published in: Am J Infect Control
October 2020

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.

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Published In

Am J Infect Control

DOI

EISSN

1527-3296

Publication Date

October 2020

Volume

48

Issue

10

Start / End Page

1148 / 1151

Location

United States

Related Subject Headings

  • Tertiary Healthcare
  • Retrospective Studies
  • Humans
  • Epidemiology
  • Cross Infection
  • Clostridium Infections
  • Clostridioides difficile
  • Clostridioides
  • 4206 Public health
  • 4202 Epidemiology
 

Citation

APA
Chicago
ICMJE
MLA
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Hostler, C. J., Bertumen, J. B., Park, L. P., Wilkins, S. B., & Woods, C. W. (2020). 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. Am J Infect Control, 48(10), 1148–1151. https://doi.org/10.1016/j.ajic.2019.12.008
Hostler, Christopher J., J Bradford Bertumen, Lawrence P. Park, Susan B. Wilkins, and Christopher W. Woods. “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.Am J Infect Control 48, no. 10 (October 2020): 1148–51. https://doi.org/10.1016/j.ajic.2019.12.008.
Hostler, Christopher J., et al. “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.Am J Infect Control, vol. 48, no. 10, Oct. 2020, pp. 1148–51. Pubmed, doi:10.1016/j.ajic.2019.12.008.
Journal cover image

Published In

Am J Infect Control

DOI

EISSN

1527-3296

Publication Date

October 2020

Volume

48

Issue

10

Start / End Page

1148 / 1151

Location

United States

Related Subject Headings

  • Tertiary Healthcare
  • Retrospective Studies
  • Humans
  • Epidemiology
  • Cross Infection
  • Clostridium Infections
  • Clostridioides difficile
  • Clostridioides
  • 4206 Public health
  • 4202 Epidemiology