Related Experiment Video
Updated: Nov 24, 2025
Culturing and Maintaining Clostridium difficile in an Anaerobic Environment
Published on: September 14, 2013
Burden and risk factors for inappropriate Clostridioides Difficile infection testing among hospitalized patients
Ellen Axenfeld1, William G Greendyke2, Jianhua Li3
1Department of Medicine, Columbia University Irving Medical Center, 630 West 168th Street, New York, NY, USA.
Background:
The purpose of this study was to identify the burden and risk factors for inappropriate Clostridioides difficile infection (CDI) testing.
Methods:
This was a retrospective cohort study among adults hospitalized between 2010 and 2019. Inappropriate CDI testing was defined as a formed stool specimen, an order within 7 days of a previously negative test, or an order within 24 hours of laxative administration.
Results:
A total of 51,302 CDI orders were placed for 29,840 unique patients. 59% were appropriate and 41% were inappropriate. An additional 24% of the appropriate orders never resulted. Risk factors for inappropriate testing included orders placed by a nurse practitioner, orders placed by high-ordering providers, specific hospital units, fever, and leukocytosis.
Conclusions:
Nearly half of all CDI orders were inappropriate among hospitalized patients, and an additional 24% of test results never returned. Provider- and patient-level risk factors included type of provider, specific hospital units, and signs of sepsis.
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