AI Article Synopsis
- - The study aimed to assess how many patients diagnosed with Clostridium difficile infection (CDI) received treatment despite having discordant test results (positive NAAT and negative EIA) and to find patient traits linked to treatment decisions.
- - Conducted in a tertiary care hospital in Geneva, Switzerland, the study focused on 208 adult patients out of 4,562 tested between March 2017 and March 2019.
- - Results showed that 71% of these patients received CDI treatment, and an abdominal CT scan indicating colitis was the main factor influencing the decision to treat, raising questions about the role of certain diagnostic tests in preventing overtreatment.
Article Abstract
Objectives: To determine the proportion of patients who received a treatment for infection (CDI) among those presenting a discordant diagnostic assay and to identify patient characteristics associated with the decision to treat CDI.
Design: Cross-sectional study.
Setting: Monocentric study in a tertiary care hospital, Geneva, Switzerland.
Participants: Among 4562 adult patients tested for between March 2017 and March 2019, 208 patients with discordant tests' results (positive nucleic acid amplification test (NAAT+)/negative enzyme immunoassay (EIA-)) were included.
Main Outcome Measures: Treatment for CDI.
Results: CDI treatment was administered in 147 (71%) cases. In multivariate analysis, an abdominal CT scan with signs of colitis (OR 14.7; 95% CI 1.96 to 110.8) was the only factor associated with CDI treatment.
Conclusions: The proportion of NAAT+/EIA- patients who received treatment questions the contribution of the EIA for the detection of toxin A/B after NAAT to limit overtreatment. Additional studies are needed to investigate if other factors are associated with the decision to treat.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7488797 | PMC |
| http://dx.doi.org/10.1136/bmjopen-2019-036342 | DOI Listing |
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