Advertisement

A qualitative study to identify reasons for Clostridium difficile testing in pediatric inpatients receiving laxatives or stool softeners

Published:March 13, 2017DOI:https://doi.org/10.1016/j.ajic.2017.01.035

      Highlights

      • Clinicians often test for C. difficile despite knowing patients are on laxatives.
      • Reasons for testing include increased loose stool or change in clinical status.
      • Prior CDI, antibiotic receipt, and comorbidities also influence decisions to test.
      • Targeted education is needed about testing after receipt of bowel medications.
      To understand why clinicians send Clostridium difficile tests from hospitalized children receiving laxatives or stool softeners, we performed a mixed-methods study. We prospectively identified tested patients and surveyed their clinicians by e-mail. Reasons for testing included changes in stooling pattern on baseline bowel regimen, other changes in clinical status, and risk factors for C difficile infection. Education targeting discontinuing bowel medications before C difficile testing could improve the specificity of pediatric C difficile infection diagnosis.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to American Journal of Infection Control
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Dubberke E.R.
        • Han Z.
        • Bobo L.
        • Hink T.
        • Lawrence B.
        • Copper S.
        • et al.
        Impact of clinical symptoms on interpretation of diagnostic assays for Clostridium difficile infections.
        J Clin Microbiol. 2011; 49: 2887-2893
        • Buckel W.R.
        • Avdic E.
        • Carroll K.C.
        • Gunaseelan V.
        • Hadhazy E.
        • Cosgrove S.E.
        Gut check: Clostridium difficile testing and treatment in the molecular testing era.
        Infect Control Hosp Epidemiol. 2015; 36: 217-221
        • Cohen S.H.
        • Gerding D.N.
        • Johnson S.
        • Kelly C.P.
        • Loo V.G.
        • McDonald L.C.
        • et al.
        Clinical practice guidelines for Clostridium difficile infection in adults: 2010 update by the society for healthcare epidemiology of America (SHEA) and the infectious diseases society of America (IDSA).
        Infect Control Hosp Epidemiol. 2010; 31: 431-455
        • Dubberke E.R.
        • Carling P.
        • Carrico R.
        • Donskey C.J.
        • Loo V.G.
        • McDonald L.C.
        • et al.
        Strategies to prevent Clostridium difficile infections in acute care hospitals: 2014 Update.
        Infect Control Hosp Epidemiol. 2014; 35: 628-645
        • Schutze G.E.
        • Willoughby R.E.
        • Committee on Infectious Diseases
        • American Academy of Pediatrics
        Clostridium difficile infection in infants and children.
        Pediatrics. 2013; 131: 196-200