Hostname: page-component-cb9f654ff-mwwwr Total loading time: 0 Render date: 2025-09-01T03:51:13.988Z Has data issue: false hasContentIssue false
  • English
  • Français

Reductions in positive Clostridioides difficile events reportable to National Healthcare Safety Network (NHSN) with adoption of reflex enzyme immunoassay (EIA) testing in 13 Atlanta hospitals

Published online by Cambridge University Press:  08 July 2021

Dana Goodenough Open the ORCID record for Dana Goodenough [Opens in a new window] ,
Samantha Sefton ,
Elizabeth Overton ,
Elizabeth Smith ,
Colleen S. Kraft ,
Jay B. Varkey  and
Scott K. Fridkin
Dana Goodenough*
Affiliation:
Foundation for Atlanta Veterans’ Education and Research, Decatur, Georgia Atlanta Veterans’ Affairs Medical Center, Decatur, Georgia Georgia Emerging Infections Program, Atlanta, Georgia
Samantha Sefton
Affiliation:
Foundation for Atlanta Veterans’ Education and Research, Decatur, Georgia Atlanta Veterans’ Affairs Medical Center, Decatur, Georgia Georgia Emerging Infections Program, Atlanta, Georgia
Elizabeth Overton
Affiliation:
Office of Quality, Emory Healthcare, Atlanta, Georgia
Elizabeth Smith
Affiliation:
Georgia Department of Public Health, Atlanta, Georgia
Colleen S. Kraft
Affiliation:
Division of Infectious Diseases, Department of Medicine, Emory University, Atlanta, Georgia
Jay B. Varkey
Affiliation:
Division of Infectious Diseases, Department of Medicine, Emory University, Atlanta, Georgia
Scott K. Fridkin
Affiliation:
Georgia Emerging Infections Program, Atlanta, Georgia Division of Infectious Diseases, Department of Medicine, Emory University, Atlanta, Georgia
*
Author for correspondence: Dana Goodenough, E-mail: dgoodenough@gaeip.org
Get access Rights & Permissions [Opens in a new window]

Abstract

In total, 13 facilities changed C. difficile testing to reflexive testing by enzyme immunoassay (EIA) only after a positive nucleic acid-amplification test (NAAT); the standardized infection ratio (SIR) decreased by 46% (range, −12% to −71% per hospital). Changing testing practice greatly influenced a performance metric without changing C. difficile infection prevention practice.

Information

Type
Concise Communication
Information
Infection Control & Hospital Epidemiology , Volume 43 , Issue 7 , July 2022 , pp. 935 - 938
Check for updates
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

Footnotes

PREVIOUS PRESENTATION. These data were previously accepted as an oral presentation by the Society for Healthcare Epidemiology of America at the 6th Decennial International Conference on Healthcare Associated Infections on March 26–30, 2020, in Atlanta, Georgia (held virtually).

References

The hospital value-based purchasing (VBP) program. Centers for Medicare and Medicaid Services website. https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments. Accessed September 14, 2020.Google Scholar
Magill, SS, Edwards, JR, Bamberg, W, et al. Multistate point-prevalence survey of health care-associated infections. N Engl J Med 2014;370:1198–1208.10.1056/NEJMoa1306801CrossRefGoogle ScholarPubMed
Medicare Program. Hospital inpatient prospective payment systems for acute-care hospitals and the long-term care hospital prospective payment system and policy changes. Department of Health and Human Services website. https://www.govinfo.gov/content. Accessed August 4, 2019.Google Scholar
Risk adjustment for healthcare facility-onset C. difficile and MRSA bacteremia laboratory-identified event reporting in NHSN. Centers for Disease Control and Prevention website. https://www.cdc.gov/nhsn/pdfs/datastat. Accessed August 4, 2020.Google Scholar
The NHSN standardized infection ratio (SIR). Centers for Disease Control and Prevention website. https://www.cdc.gov/nhsn/pdfs/ps-analysis-resources. Accessed August 4, 2020.Google Scholar
Marra, AR, Edmond, MB, Ford, BA, Herwaldt, LA, Algwizani, AR, Diekema, DJ. Failure of risk-adjustment by test method for C. difficile laboratory-identified event reporting. Infect Control Hosp Epidemiol 2017;38:109–11.CrossRefGoogle ScholarPubMed
Thompson, N, Edwards, J, Dudeck, M, Fridkin, S, Magill, S. Evaluating the use of the case mix index for risk adjustment of healthcare-associated infection data: an illustration using Clostridium difficile infection data from the National Healthcare Safety Network. Infect Control Hosp Epidemiol 2016;37:19–25.10.1017/ice.2015.252CrossRefGoogle ScholarPubMed
Figueroa Castro, CE, Palen, L, Johnson, C, et al. Immediate impact of healthcare-facility–onset Clostridium difficile laboratory-identified events reporting methodology change on standardized infection ratios. Infect Control Hosp Epidemiol 2018;39:1484–1486.CrossRefGoogle ScholarPubMed
Magill, SS, Dumyati, G, Ray, SM, Fridkin, SK. Evaluating epidemiology and improving surveillance of infections associated with health care, United States. Emerg Infect Dis 2015;21:1537–1542.CrossRefGoogle ScholarPubMed
Polage, CR, Gyorke, CE, Kennedy, MA, et al. Overdiagnosis of Clostridium difficile infection in the molecular test era. JAMA Intern Med 2015;175:1792–1801.CrossRefGoogle ScholarPubMed