Volume 24, Number 9—September 2018
CME ACTIVITY - Synopsis
National Surveillance for Clostridioides difficile Infection, Sweden, 2009–2016
Kristina Rizzardi, Torbjörn Norén, Olov Aspevall, Barbro Mäkitalo, Michael Toepfer, Åsa Johansson, and Thomas Åkerlund
Table
Comparison of CDI positivity rates for clinical laboratories that switched methods during the 2009–2016 study period, Sweden*
| Change in testing algorithm | Year algorithm was switched | Mean no. positive samples (mean positivity, %) | p value† | Change in positivity after switch, % | Local CDI‡ incidence change 2012–2016, % | |
|---|---|---|---|---|---|---|
| 2 y before switch | 2 y after switch | |||||
| EIA to NAAT | ||||||
| Laboratory 1 | 2011 | 698 (21) | 672 (19) | 0.004 | −9 | −52 |
| Laboratory 2 | 2011 | 176 (13) | 355 (16) | <0.001 | +24 | −31 |
| Laboratory 3 | 2011 | 101 (12) | 168 (16) | <0.001 | +36 | −9 |
| Laboratory 4 | 2011 | 635 (22) | 506 (19) | <0.001 | −13 | +6 |
| Laboratory 5 | 2012 | 322 (15) | 312 (17) | 0.013 | +14 | −27 |
| Laboratory 6 | 2013 | 416 (22) | 377 (18) | <0.001 | −18 | −34 |
| Laboratory 7 | 2013 | 346 (16) | 300 (12) | <0.001 | −27 | −28§ |
| Laboratory 8 | 2013 | 176 (11) | 272 (14) | <0.001 | +25 | −28§ |
| Total | 359 (18) | 370 (17) | <0.001 | −7 | ||
| Cytotox to NAAT | ||||||
| Laboratory 9¶ | 2012 | 124 (7) | 353 (20) | <0.001 | +68 | +67 |
| Laboratory 10 | 2013 | 1,398 (13) | 1233(11) | <0.001 | −18 | −9§ |
| Total | 761 (12) | 793 (12) | 0.358 | −2 | ||
| Cytotox to EIA + GDH | ||||||
| Laboratory 11 | 2014 | 294 (17) | 273 (13) | <0.001 | −22 | −35 |
| NAAT to EIA + NAAT | ||||||
| Laboratory 12 | 2014 | 388 (19) | 290 (14) | <0.001 | −27 | −44 |
| EIA to EIA + NAAT | ||||||
| Laboratory 13 | 2014 | 677 (17) | 420 (13) | <0.001 | −21 | −35 |
*CDI, Clostridioides difficile infection; EIA, enzyme immunoassay; GDH, glutamate dehydrogenase assay; NAAT, nucleic acid amplification testing.
†By χ2 test.
‡CDI incidence/100,000 population. Local incidence data from before 2012 not available.
§Data from >1 laboratory is included in local CDI incidence rates.
¶This laboratory used a nonstandardized cell cytotoxicity assay.
Page created: September 13, 2018
Page updated: September 13, 2018
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