Discordant Clostridioides difficile diagnostic assay and treatment practice: a cross-sectional study in a tertiary care hospital, Geneva, Switzerland
Objectives To determine the proportion of patients who received a treatment for Clostridioides difficile infection (CDI) among those presenting a discordant C. difficile diagnostic assay and to identify patient characteristics associated with the decision to treat CDI.Design Cross-sectional study.Se...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2020-09-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/10/9/e036342.full |
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| author | Antoine Poncet Laurent Kaiser Lauriane Lenggenhager Marie-Céline Zanella Jacques Schrenzel |
| author_facet | Antoine Poncet Laurent Kaiser Lauriane Lenggenhager Marie-Céline Zanella Jacques Schrenzel |
| author_sort | Antoine Poncet |
| collection | DOAJ |
| description | Objectives To determine the proportion of patients who received a treatment for Clostridioides difficile infection (CDI) among those presenting a discordant C. difficile diagnostic assay and to identify patient characteristics associated with the decision to treat CDI.Design Cross-sectional study.Setting Monocentric study in a tertiary care hospital, Geneva, Switzerland.Participants Among 4562 adult patients tested for C. difficile between March 2017 and March 2019, 208 patients with discordant tests’ results (positive nucleic acid amplification test (NAAT+)/negative enzyme immunoassay (EIA−)) were included.Main outcome measures Treatment for CDI.Results CDI treatment was administered in 147 (71%) cases. In multivariate analysis, an abdominal CT scan with signs of colitis (OR 14.7; 95% CI 1.96 to 110.8) was the only factor associated with CDI treatment.Conclusions The proportion of NAAT+/EIA− patients who received treatment questions the contribution of the EIA for the detection of toxin A/B after NAAT to limit overtreatment. Additional studies are needed to investigate if other factors are associated with the decision to treat. |
| format | Article |
| id | doaj-art-fcae23d8351848cabec499e9bd6575d3 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2020-09-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-fcae23d8351848cabec499e9bd6575d32025-01-07T11:30:14ZengBMJ Publishing GroupBMJ Open2044-60552020-09-0110910.1136/bmjopen-2019-036342Discordant Clostridioides difficile diagnostic assay and treatment practice: a cross-sectional study in a tertiary care hospital, Geneva, SwitzerlandAntoine Poncet0Laurent Kaiser1Lauriane Lenggenhager2Marie-Céline Zanella3Jacques Schrenzel4Department of Health and Community Medicine, University of Geneva, Geneva, SwitzerlandDivision of Infectious Diseases, Geneva University Hospitals, Geneve, SwitzerlandDivision of Infectious Diseases, Geneva University Hospitals, Geneve, SwitzerlandDivision of Infectious Diseases, Geneva University Hospitals, Geneve, SwitzerlandDivision of Infectious Diseases, Geneva University Hospitals, Geneve, SwitzerlandObjectives To determine the proportion of patients who received a treatment for Clostridioides difficile infection (CDI) among those presenting a discordant C. difficile diagnostic assay and to identify patient characteristics associated with the decision to treat CDI.Design Cross-sectional study.Setting Monocentric study in a tertiary care hospital, Geneva, Switzerland.Participants Among 4562 adult patients tested for C. difficile between March 2017 and March 2019, 208 patients with discordant tests’ results (positive nucleic acid amplification test (NAAT+)/negative enzyme immunoassay (EIA−)) were included.Main outcome measures Treatment for CDI.Results CDI treatment was administered in 147 (71%) cases. In multivariate analysis, an abdominal CT scan with signs of colitis (OR 14.7; 95% CI 1.96 to 110.8) was the only factor associated with CDI treatment.Conclusions The proportion of NAAT+/EIA− patients who received treatment questions the contribution of the EIA for the detection of toxin A/B after NAAT to limit overtreatment. Additional studies are needed to investigate if other factors are associated with the decision to treat.https://bmjopen.bmj.com/content/10/9/e036342.full |
| spellingShingle | Antoine Poncet Laurent Kaiser Lauriane Lenggenhager Marie-Céline Zanella Jacques Schrenzel Discordant Clostridioides difficile diagnostic assay and treatment practice: a cross-sectional study in a tertiary care hospital, Geneva, Switzerland BMJ Open |
| title | Discordant Clostridioides difficile diagnostic assay and treatment practice: a cross-sectional study in a tertiary care hospital, Geneva, Switzerland |
| title_full | Discordant Clostridioides difficile diagnostic assay and treatment practice: a cross-sectional study in a tertiary care hospital, Geneva, Switzerland |
| title_fullStr | Discordant Clostridioides difficile diagnostic assay and treatment practice: a cross-sectional study in a tertiary care hospital, Geneva, Switzerland |
| title_full_unstemmed | Discordant Clostridioides difficile diagnostic assay and treatment practice: a cross-sectional study in a tertiary care hospital, Geneva, Switzerland |
| title_short | Discordant Clostridioides difficile diagnostic assay and treatment practice: a cross-sectional study in a tertiary care hospital, Geneva, Switzerland |
| title_sort | discordant clostridioides difficile diagnostic assay and treatment practice a cross sectional study in a tertiary care hospital geneva switzerland |
| url | https://bmjopen.bmj.com/content/10/9/e036342.full |
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