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Failure of Risk-Adjustment by Test Method for C. difficile Laboratory-Identified Event Reporting

Published online by Cambridge University Press:  17 October 2016

Alexandre R. Marra ,
Michael B. Edmond ,
Bradley A. Ford ,
Loreen A. Herwaldt ,
Abdullah R. Algwizani  and
Daniel J. Diekema
Alexandre R. Marra*
Affiliation:
Office of Clinical Quality, Safety, and Performance Improvement, University of Iowa Hospitals and Clinics, Iowa City, Iowa Division of Medical Practice, Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
Michael B. Edmond
Affiliation:
Office of Clinical Quality, Safety, and Performance Improvement, University of Iowa Hospitals and Clinics, Iowa City, Iowa Division of Infectious Diseases, Department of Internal Medicine, University of Iowa, Carver College of Medicine, Iowa City, Iowa
Bradley A. Ford
Affiliation:
Division of Medical Microbiology, Department of Pathology, University of Iowa, Carver College of Medicine
Loreen A. Herwaldt
Affiliation:
Division of Infectious Diseases, Department of Internal Medicine, University of Iowa, Carver College of Medicine, Iowa City, Iowa
Abdullah R. Algwizani
Affiliation:
Office of Clinical Quality, Safety, and Performance Improvement, University of Iowa Hospitals and Clinics, Iowa City, Iowa
Daniel J. Diekema
Affiliation:
Office of Clinical Quality, Safety, and Performance Improvement, University of Iowa Hospitals and Clinics, Iowa City, Iowa Division of Infectious Diseases, Department of Internal Medicine, University of Iowa, Carver College of Medicine, Iowa City, Iowa Division of Medical Microbiology, Department of Pathology, University of Iowa, Carver College of Medicine
*
Address correspondence to Alexandre Rodrigues Marra, MD, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52242 ([email protected]).
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Abstract

Using an algorithm including both enzyme immunoassay (EIA) and nucleic acid amplification (NAAT) for Clostridium difficile infection (CDI) diagnosis, we found that the use of NAAT versus EIA almost doubled our hospital-onset CDI laboratory-identified (LabID) event standardized infection ratio (SIR). We recommend that the current risk adjustment approach be modified.

Infect Control Hosp Epidemiol 2016:1–3

Type
Concise Communications
Information
Infection Control & Hospital Epidemiology , Volume 38 , Issue 1 , January 2017 , pp. 109 - 111
Copyright
© 2016 by The Society for Healthcare Epidemiology of America. All rights reserved 

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References

REFERENCES

1. Centers for Disease Control and Prevention. Vital signs: preventing Clostridium difficile infections. MMWR 2012;61:157–162.Google Scholar
2. Miller, BA, Chen, LF, Sexton, DJ, Anderson, DJ. Comparision of the burdens of hospital-onset, healthcare facility-associated Clostridium difficile Infection and of healthcare-associated infection due to methicillin-resistant Staphylococcus aureus in community hospitals. Infect Control Hosp Epidemiol 2011;32:387–390.Google Scholar
3. Healthcare-Associated Infections Progress Report. Centers for Disease Control and Prevention website. http://www.cdc.gov/hai/surveillance/progress-report/. Updated 2016. Accessed April 12, 2016.Google Scholar
4. National Healthcare Safety Network. Multidrug-resistant organism and Clostridium difficile infection (MDRO/CDI) module. Centers for Disease Control and Prevention website. http://www.cdc.gov/nhsn/ltach/cdiff-mrsa/index.html. Published 2009. Accessed April 12, 2015.Google Scholar
5. Hospital Compare. Centers for Medicare and Medicaid Services website. https://www.medicare.gov/hospitalcompare/search.html. Updated 2016. Accessed April 12, 2016.Google Scholar
6. Hospital Value-Based Purchasing. Centers for Medicare and Medicaid Services website. https://www.cms.gov/Medicare/Quality-initiatives-patient-assessment-instruments/hospital-value-based-purchasing/index.html. Updated 2016. Accessed April 12, 2016.Google Scholar
7. Bartsch, SM, Umscheid, CA, Nachamkin, I, Hamilton, K, Lee, BY. Comparing the economic and health benefits of different approaches to diagnosing Clostridium difficile infection. Clin Microbiol Infect 2015;21:1–9.Google Scholar
8. Koo, HL, Van, JN, Zhao, M, et al. Real-time polymerase chain reaction detection of asymptomatic Clostridium difficile colonization and rising C. difficile-associated disease rates. Infect Control Hosp Epidemiol 2014;35:667–673.CrossRefGoogle Scholar
9. Polage, CR, Gyorke, CE, Kennedy, MA, et al. Overdiagnosis of Clostridium difficile in the molecular test era. JAMA Intern Med 2015;175:1792–1801.Google Scholar
10. Moehring, RW, Lofgren, ET, Anderson, DJ. Impact of change to molecular testing for Clostridium difficile infection on healthcare facility-associated incidence rates. Infect Control Hosp Epidemiol 2013;34:1055–1061.Google Scholar
11. Dudeck, MA, Weiner, LM, Malpiedi, PJ, et al. Risk adjustment for healthcare facility-onset C. difficile and MRSA bacteremia laboratory-identified event reporting in NHSN. Centers for Disease Control and Prevention website. http://www.cdc.gov/nhsn/pdfs/mrsa-cdi/RiskAdjustment-MRSA-CDI.pdf. Published 2013. Accessed September 13, 2016.Google Scholar
12. Talbot, TR, Bratzler, DW, Carrico, RM, et al. Public reporting of healthcare-associated surveillance data: recommendations from the Healthcare Infection Control Practices Advisory Committee. Ann Intern Med 2013;159:631–635.Google Scholar
13. Updated guidance on the diagnosis and reporting of Clostridium difficile. United Kingdom National Health Service website. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/215135/dh_133016.pdf. Published 2012. Accessed April 15, 2016.Google Scholar