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A Protocol to Characterize the Morphological Changes of Clostridium difficile in Response to Antibiotic Treatment
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A qualitative study to identify reasons for Clostridium difficile testing in pediatric inpatients receiving laxatives

Joanne Kinlay1, Thomas J Sandora1

  • 1Infection Prevention and Control, Boston Children's Hospital, Boston, MA.

American Journal of Infection Control
|March 18, 2017
PubMed

Insights

Clinicians often test hospitalized children for Clostridium difficile infection due to bowel regimen changes or clinical status shifts. Educating on stopping laxatives before testing can improve diagnosis accuracy for pediatric C. difficile infections.

Area of Science:

  • Pediatric Infectious Diseases
  • Gastroenterology
  • Clinical Microbiology

Background:

  • Hospitalized children receiving laxatives or stool softeners are frequently tested for Clostridium difficile infection.
  • Understanding the rationale behind these tests is crucial for accurate diagnosis and appropriate treatment.

Purpose of the Study:

  • To investigate the reasons why clinicians order Clostridium difficile tests for hospitalized pediatric patients on bowel medications.
  • To identify factors contributing to the diagnostic challenges of C. difficile infection in this population.

Main Methods:

  • A mixed-methods study was conducted.
  • Prospective identification of pediatric patients undergoing C. difficile testing.
  • Clinician surveys via email to gather reasons for testing.

Main Results:

  • Key reasons for testing included changes in stooling patterns within the established bowel regimen.
  • Other clinical status changes and identified risk factors for C. difficile infection also prompted testing.
  • Clinician education on medication management before testing is suggested.

Conclusions:

  • Discontinuing laxatives and stool softeners prior to Clostridium difficile testing can enhance diagnostic specificity.
  • Targeted education for clinicians may optimize the diagnosis of pediatric C. difficile infections.

Keywords:
Bowel medicationsChildrenDiagnosisDiarrhea

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