Only 62% of reported facility-onset C. diff are accurately diagnosed

A study published in the American Journal of Infection Control investigated potential over-reporting of healthcare facility-onset Clostridium difficile infection.

Researchers performed retrospective chart review on 212 healthcare facility-onset C. diff, or HO-CDI, cases reported at a large urban medical center in 2015. The cases were categorized into clinical surveillance groups: community-acquired infection; recurrence/relapse; asymptomatic colonization; colonization with self-limited symptoms; possible HO-CDI; and probable HO-CDI.

Researchers found of the 212 infections:

• 13.6 percent were community acquired
• 2.8 percent were recurrent/relapse
• 1.9 percent were asymptomatic colonization
• 18.4 percent were symptomatic colonization
• 38.7 percent were possible HO-CDI
• 24.5 percent were probable HO-CDI

Within 24 hours of testing, 34.1 percent of patients had received a stool softener and/or laxative.

"Laxative use and failure to identify community-onset infection may contribute to misclassification of HO-CDI," researchers concluded.

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