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Volume 29, Number 5—May 2023
Research

Misdiagnosis of Clostridioides difficile Infections by Standard-of-Care Specimen Collection and Testing among Hospitalized Adults, Louisville, Kentucky, USA, 2019–20201

Julio A. Ramirez2, Frederick J. AnguloComments to Author , Ruth M. Carrico2, Stephen Furmanek2, Senén Peña Oliva, Joann M. Zamparo, Elisa Gonzalez, Pingping Zhang, Leslie A. Wolf Parrish, Subathra Marimuthu, Michael W. Pride, Sharon Gray, Cátia S. Matos Ferreira3, Forest W. Arnold, Raul E. Istúriz, Nadia Minarovic, Jennifer C. Moïsi, and Luis Jodar
Author affiliations: University of Louisville, Louisville, Kentucky, USA (J.A. Ramirez, R.M. Carrico, S. Furmanek, S. Peña Oliva, L.A. Wolf Parrish, S. Marimuthu, F.W. Arnold); Pfizer Vaccines, Collegeville, Pennsylvania, USA (F.J. Angulo, J.M. Zamparo, E. Gonzalez, P. Zhang, S. Gray, C.S. Matos Ferreira, R.E. Istúriz, N. Minarovic, J.C. Moïsi, L. Jodar); Pfizer, Pearl River, New York, USA (M.W. Pride)

Main Article

Table 1

Hospital-based incidence of diarrhea, enrollment rate, stool collection rate, and CDI testing density in participating hospitals before the COVID-19 pause in study of misdiagnosis of CDI by SOC specimen collection and testing among hospitalized adults, Louisville, Kentucky, USA, October 14, 2019–April 11, 2020*

Hospital† No. adult hospital beds Surveillance initiation date, 2019 No. eligible patient-days of surveillance No. incident diarrhea cases identified Diarrhea incidence‡ No. (%) incident diarrhea cases enrolled No. (%) study stool specimens collected from enrolled cases Study CDI stool specimen testing rate, % Study CDI testing density§
A 671 Oct 14 19,166 195 101.7 163 (83.6) 123 (75.5) 63.1 64.2
B 377 Oct 14 16,252 328 201.8 282 (86.0) 259 (91.8) 79.0 159.4
C 367 Oct 14 11,658 247 211.9 208 (84.2) 183 (88.0) 74.1 157.0
D 348 Oct 14 8,723 143 163.9 122 (85.3) 98 (80.3) 68.5 112.3
E 336 Nov 4 11817 281 237.8 218 (77.6) 133 (61.0) 47.3 112.5
F 200 Dec 23 4,256 41 96.3 32 (78.0) 21 (65.6) 51.2 49.3
G 170 Nov 4 5,754 146 253.7 120 (82.2) 98 (81.7) 67.1 170.3
H
127
 Oct 14
 8,093
 160
 197.7
 138 (86.3)
 132 (95.7)
 82.5
 163.1
Total 2,596 Oct 14–Dec 23 85,719 1,541 179.8 1,283 (83.3) 1,047 (81.6) 67.9 122.1

*CDI, Clostridioides difficile infection; SOC, standard-of-care. †Participating hospitals are listed in descending order of the number of adult hospital beds. ‡Cases per 10,000 patient-days. §Tests per 10,000 patient‑days.

Main Article

1Study results were presented at the annual Anaerobe 2022 Congress, July 28–31, 2022, Seattle, Washington, USA.

2Current affiliation: Norton Healthcare, Louisville, Kentucky, USA.

3Current affiliation: AstraZeneca Pharmaceuticals, Wilmington, Delaware, USA.

Page created: March 10, 2023
Page updated: April 18, 2023
Page reviewed: April 18, 2023
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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