Table 2.
Outcomes After a Negative, Prevented, or Positive C. difficile Test
| Outcomes | Prevented (n = 147) | Negative (n = 490) | P | Positive (n = 131) | P |
|---|---|---|---|---|---|
| Inpatient mortality or ICU transfer | 23 (15.6) | 94 (19.2) | .395 | 29 (22.1) | .166 |
| Inpatient mortality | 4 (2.7) | 32 (6.5) | .101 | 14 (10.7) | .007 |
| ICU transfer | 22 (15.0) | 72 (14.7) | .999 | 17 (13.0) | .634 |
| Length of stay, median (IQR), d | 6 (3–13.5) | 9 (4–20) | .004 | 9 (4–19) | .012 |
| New/increased leukocytosis (WBC >11×109/L)a | 32 (25.2) | 142 (31.6) | .189 | 51 (37.0) | .039 |
| Serum creatinine increase >1.5× a | 15 (11.5) | 60 (12.7) | .888 | 12 (8.2) | .356 |
| Colectomy | 0 (0.0) | 10 (2.0) | .127 | 1 (0.7) | .321 |
| Repeat test performed within 7 d of initial attempt | 54 (36.7) | 33 (6.7) | <.001 | 2 (1.3) | <.001 |
| Negative | 43 (29.3) | 32 (6.5) | <.001 | 1 (0.7) | <.001 |
| Positive | 11 (7.5) | 1 (0.2) | <.001 | 1 (0.7) | .003 |
| Rejected by laboratory | 3 (2.0) | 2 (0.4) | .083 | 0 (0.0) | .079 |
| 2nd repeat test within 7 db | 5 (3.4) | 4 (0.8) | .034 | 0 (0.0) | .023 |
| Anti-CDI treatmentc | 33 (22.4) | 110 (22.4) | .999 | ||
| Metronidazole (IV/PO)d | 30 (20.4) | 103 (21.0) | .908 | ||
| Vancomycin (PO) | 10 (6.8) | 13 (2.7) | .024 | ||
| Vancomycin (PO) w/o a (+) teste | 0 (0.0) | 6 (2.0) | .345 |
Data presented as No./total available data (%) unless otherwise indicated. P values represent comparisons with prevented group.
Abbreviations: CDI, Clostridioides difficile infection; dx, diagnosis; ICU, intensive care unit; IQR, interquartile range; IV, intravenous; PO, per os (includes medications administered rectally or per enteric tube); PR, per rectum; WBC, white blood cell count.
aWhite blood cell and creatinine data missing for 41 and 18 cases, respectively.
bResults of all second repeated tests within 7 days of the initial test attempt were negative.
cTreatment for CDI refers to PO vancomycin or PO metronidazole at any point after CCDS trigger until hospital discharge. Treatment was not assessed for positives.
dChart review revealed no prevented patients who received metronidazole for CDI without a recent positive test result to justify treatment.
dCases of oral vancomycin treatment without a recent positive test identified by chart review.