Friday, 2 August 2019

Universal Screening to Combat Healthcare-Associated Infections


Clostridium difficile infections (CDI) are a serious threat to public health. This often-deadly pathogen is the leading cause of healthcare-associated infections in the United States, representing nearly 500,000 cases annually. It is imperative that we find effective ways to curb its transmission, particularly within hospitals and other healthcare facilities, in order to improve patient outcomes and overall human health.

Existing guidelines for testing possible CDI cases restrict the use of molecular diagnostics to very specific patient profiles. However, new studies have begun to demonstrate that a broader approach to C. difficile testing—comprehensive screening of patients admitted to hospitals—could offer significant progress toward reducing the incidence of nosocomial transmission.
Modifying the way molecular diagnostics are used for this pathogen could dramatically reduce the number of people infected with C. difficile by allowing earlier identification and mitigation steps that can limit its ability to spread. Since these infections often lead to chronic health problems or even death, any reduction in incidence would provide a major improvement to human health.

In recent years, the guidelines for C. difficile testing have changed. The guidance issued last year by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America recommends using molecular diagnostics in a fairly narrow way. The primary driver behind this decision is that molecular tests cannot differentiate between cases where C. difficile is the causal pathogen and where it is a harmless member of the patient’s intestinal microbiome.


To avoid overdiagnosis of CDI, these guidelines suggest using molecular diagnostics only when healthcare professionals have reason to believe the patient is suffering from an active CDI. This is typically when a patient has recently undergone antibiotic treatment or has experienced the onset of symptoms after being admitted to the hospital for a number of days. In these cases, the rapid turnaround time for a molecular assay offers an advantage for guiding isolation and treatment.

For further information, see Diagnostics World at: http://www.diagnosticsworldnews.com/2019/03/05/universal-screening-combat-healthcare-associated-infections.aspx

Posted by Dr. Tim Sandle, Pharmaceutical Microbiology

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