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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 4

Comparison between enrolled and nonenrolled incident diarrhea cases before the COVID-19 pause (n = 1,490) in study of misdiagnosis of CDI by SOC specimen collection and testing among hospitalized adults, Louisville, Kentucky, USA, October 14, 2019–April 11, 2020*

Characteristic Enrolled, n =1,249 Nonenrolled, n = 241 p value
Demographics
Median age, y 68 68 NA
Female sex 737 (59) 119 (49) <0.01
Black
 297 (24)
 62 (26)
 0.52
Medical history
Heart disease 638 (51) 131 (54) 0.35
Cancer 371 (30) 57 (24) 0.06
Stroke 235 (19) 41 (17) 0.51
Dementia 85 (7) 27 (11) 0.02
Antimicrobial drug use in past 2 weeks
 370 (30)
 74 (31)
 0.74
Admission diagnosis
Heart disease 131 (10) 26 (11) 0.89
Respiratory disease 105 (8) 21 (9) 0.88
Pneumonia 95 (8) 20 (8) 0.71
Nervous system disease
 61 (5)
 21 (9)
 0.02
Medical course
Transferred to ICU 297 (24) 73 (30) 0.03
Death in 90 days 152 (12) 53 (22) <0.01

*Values are no. (%) except as indicated. Surveillance ascertained 1,541 incident diarrhea cases. Medical record review was conducted at 7 of 8 participating hospitals. Hospital F, where 41 incident diarrhea cases were ascertained, did not participate in medical record review. Data from 10 medical records at hospitals A–E, G, and H were not available for this analysis. Data are presented in descending order, where applicable, of Enrolled column. CDI, Clostridioides difficile infection; ICU intensive care unit; NA, not applicable; SOC, standard-of-care.

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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