Table 1.
Demographic, Clinical, and Testing Characteristics of Patients With C. difficile Infection From FY2015 to FY2018
| Variable | FY2015 | FY2016 | FY2017 | FY2018 | P Valuea |
|---|---|---|---|---|---|
| Age, median y (IQR) | 69 (61–78) | 69 (63–71) | 67 (62–74) | 71 (67–78) | .32 |
| Gender b | |||||
| Male | 42 (95.5) | 35 (97.2) | 32 (94.1) | 13 (100) | .92 |
| Female | 2 (4.5) | 1 (2.8) | 2 (5.9) | 0 (0) | .92 |
| Clinical characteristics b | |||||
| Diabetes mellitus | 17 (38.6) | 11 (30.6) | 12 (35.3) | 5 (38.4) | .55 |
| End-stage renal disease | 4 (9.1) | 2 (5.6) | 5 (14.7) | 1 (7.6) | .46 |
| Prior C. difficile infection | 6 (13.6) | 8 (22.2) | 6 (17.6) | 2 (15.4) | .61 |
| Antibiotic use within 3 mo | 36 (81.8) | 31 (86.1) | 30 (88.2) | 10 (76.9) | .75 |
| Laxatives (initiation or escalation)c | 20 (45.5) | 14 (38.9) | 11 (32.3) | 4 (30.1) | .62 |
| Tube Feeds (initiation)c | 7 (15.9) | 1 (2.8) | 5 (14.7) | 1 (7.7) | .20 |
| Proton pump inhibitor use | 26 (59.1) | 21 (58.3) | 16 (47.1) | 1 (7.7) | .006 |
| Immunosuppressiond | 8 (18.2) | 7 (19.4) | 10 (29.4) | 4 (30.8) | .39 |
| Testing | |||||
| + C. difficile NAAT | 44 | 36 | 34 | 13 | <.001 |
| Total C. difficile NAAT performed | 459 | 188 | 130 | 124 | … |
| % of + C. difficile NAAT | 9.6 | 19.1 | 26.2 | 10.5 | … |
| % of C. difficile NAAT performede | 7.9 | 3.5 | 2.3 | 2.1 | |
| Inpatient admissionsf | 5,840 (0.8) | 5,387 (0.7) | 5,651 (0.6) | 5,868 (0.2) | … |
Abbreviations: FY, fiscal year; IQR, interquartile range; NAAT, nucleic acid amplification test.
ANOVA, χ2, or Fisher exact tests were used to analyze numeric variables and C. difficile cases identified before and after diagnostic stewardship intervention (FY2017 vs FY2018). P ≤ .05 was considered significant for all statistical tests.
Data are represented as no. (%) of positive C. difficile toxin B gene NAAT unless otherwise specified.
No. of patients identified to be on laxatives or tube feeds within 24–48 h of C. difficile NAAT.
Immunosuppression defined as any patient treated with systemic corticosteroids, immunomodulatory or biologic therapy, and/or chemotherapy within 3 months of C. difficile infection diagnosis.
Percentage of C. difficile NAAT performed is the total inpatient admissions divided by total C. difficile NAAT performed × 100.
Inpatient admissions are represented as total numbers of patients admitted per fiscal year to units where cases of hospital-onset, healthcare facility–associated C. difficile infection were identified and (%) of positive C. difficile toxin B gene NAAT.