Factors associated with repeat Clostridioides difficile testing in VA medical centers

Area of Science:

• Infectious Diseases
• Clinical Microbiology
• Healthcare Quality

Background:

• Clostridioides difficile infection (CDI) is a significant healthcare-associated infection.
• Current guidelines recommend against repeat diagnostic testing for CDI within 7 days of a previous positive test.
• Inappropriate repeat testing can lead to increased healthcare costs and potential patient harm.

Purpose of the Study:

• To identify factors associated with ordering repeat diagnostic tests for Clostridioides difficile infection within 7 days.
• To evaluate the impact of healthcare provider type on the frequency of 7-day repeat testing for CDI.

Main Methods:

• Retrospective cohort study design.
• Analysis of electronic health records to identify CDI testing patterns.
• Statistical analysis, including adjusted odds ratios (aOR), to determine factors associated with repeat testing.

Main Results:

• Residents ordered repeat Clostridioides difficile infection tests more frequently compared to attending physicians (aOR = 0.67) and advanced practice practitioners (aOR = 0.61).
• Provider type was a significant factor associated with 7-day repeat testing.
• Further investigation is warranted to understand the drivers of these testing disparities.

Conclusions:

• Provider experience and training level may influence adherence to CDI testing guidelines.
• Targeted interventions may be necessary to reduce inappropriate 7-day repeat testing for CDI.
• Optimizing diagnostic strategies for CDI is crucial for effective patient management and resource utilization.