Is CDC's C. diff framework effective? Jury is still out, study finds

The CDC's framework to prevent healthcare-associated Clostridioides difficile infections may have potential benefits for hospitals, but further research is needed to fully understand its effectiveness, according to a study published March 27 in JAMA Network Open.

A team led by researchers at Durham, N.C.-based Duke University Medical Center analyzed C. difficile rates among 46 hospitals in the Duke Infection Control Outreach Network between July 1, 2019, and March 31, 2022. Twenty hospitals implemented the CDC's framework recommendations while the remaining 26 served as controls. 

Researchers found the CDC recommendations were not associated with a reduced incidence of C. difficile infections over time. Hospitals implementing the framework saw a steeper decline in incidence compared to the control group, but researchers found infections were already falling before the study started. 

Framework implementation rates also fell significantly at the start of the pandemic, making it harder for researchers to fully assess its potential benefit. 

"Besides highlighting the need for robust infection prevention infrastructure (capable of dealing with routine duties and the occasional pandemic), the dose-dependent association of framework measures with the decline in [hospital-onset C. difficile] cases suggests that HO-CDI prevention hinges heavily on how effectively framework measures are implemented," researchers said.

Read the full study here.

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