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A Protocol to Characterize the Morphological Changes of Clostridium difficile in Response to Antibiotic Treatment
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[Clostridium difficile, are all our patients diagnosed?].

P Alonso-Fernández1, T I Wu Lai1, M García-Salmones1

  • 1Servicio de Geriatría, Hospital Clínico San Carlos, Madrid, España.

Revista De Calidad Asistencial : Organo De La Sociedad Espanola De Calidad Asistencial
|March 7, 2015
PubMed
Summary

Accurate Clostridium difficile infection (CDI) diagnosis is crucial. Nearly half of patients with CDI lacked a clinical diagnosis in reports, leading to less treatment and higher mortality.

Keywords:
Clostridium difficileComorbidityComorbilidadDiagnosisDiagnóstico clínicoHospitalizaciónHospitalization

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Area of Science:

  • Infectious Diseases
  • Clinical Diagnostics
  • Healthcare Management

Background:

  • Accurate diagnosis of Clostridium difficile infection (CDI) is vital for assessing severity and guiding patient and population management.
  • Establishing a strong correlation between clinical and microbiological diagnoses is essential for effective CDI care.

Purpose of the Study:

  • To assess the correlation between microbiological and clinical diagnoses in CDI patients.
  • To investigate if diagnostic discrepancies are linked to patient characteristics, treatment, and outcomes.

Main Methods:

  • Retrospective analysis of inpatient data from 2013 at Hospital Clínico San Carlos, Madrid.
  • Inclusion of patients with a microbiological CDI diagnosis, examining the presence of ICD diagnosis in clinical reports.
  • Evaluation of clinical characteristics, therapeutic approaches, and patient outcomes based on diagnostic inclusion.

Main Results:

  • Out of 33,317 discharged patients, 204 had CDI; only 51.5% had the diagnosis in their discharge report.
  • Patients with clinical diagnosis included were older, more dependent, and received CDI treatment more often.
  • Lower CDI treatment rates correlated with increased mortality (P=.032).

Conclusions:

  • Approximately half of patients with microbiological CDI diagnosis lacked it in their clinical records.
  • Patients without a documented clinical diagnosis were younger, less disabled, and received CDI-specific antibiotics less frequently.
  • Failure to receive specific CDI antibiotics was associated with higher mortality rates.