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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 5

Comparison between inpatients who had a stool specimen collected for CDI testing and inpatients who did not among incident diarrhea cases enrolled before COVID-19 pause (n = 1,283) 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 Study stool specimen collected, n = 1,047 Study stool specimen
not collected, n = 236		 p value
Demographics
Median age, y (IQR) 68 (61–78) 67.5 (60–77) 0.46
Female sex 595 (56.8) 146 (61.9) 0.16
Black 218 (21.5) 81 (34.8) <0.01
Hispanic
 18 (1.8)
 2 (0.9)
 0.33
Signs and symptoms
Abdominal pain 283 (28.7) 53 (23.8) 0.14
Fever 109 (10.7) 18 (7.8) 0.18
Blood or pus in stool
 90 (9.3)
 20 (9.0)
 0.91
Medical history
Overnight stay in healthcare facility in previous 12 weeks 615 (60) 150 (63.8) 0.39
Diabetes 432 (41.5) 91 (38.9) 0.46
Antimicrobial drug use in previous 3 months 387 (39.2) 63 (26.9) < 0.01
Cancer 313 (30.2) 59 (25.1) 0.12
Congestive heart disease 305 (29.3) 64 (27.2) 0.53
CDI in past 5 years 66 (7.5) 18 (8.1) 0.76
Dementia 76 (7.3) 14 (5.9) 0.46
Inflammatory bowel disease 65 (6.3) 10 (4.3) 0.26
Hemiplegia/quadriplegia 54 (5.2) 8 (3.4) 0.25

*Values are no. (%) except as indicated. Data are presented in descending order of Study stool specimen collected column. Values of missing or unknown were excluded from percentage and p value calculations. CDI, Clostridioides difficile infection; IQR, interquartile range; 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
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