Lab Med Qual Assur.  2020 Jun;42(2):77-83. 10.15263/jlmqa.2020.42.2.77.

Diagnostic Stewardship on the Extra-Analytical Phase to Secure Quality Assurance of Diagnostic Tests for Clostridioides difficile Infection

Affiliations
  • 1Department of Laboratory Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea

Abstract

Background
Clostridioides difficile infection (CDI) is the most essential cause of antimicrobial-related diarrhea in hospitalized patients. It is also considered as an important hospital-acquired infection. Adequately performing the laboratory diagnostic tests for CDI is critical for the control and treatment of CDI in healthcare facilities. This study focused on the management of the extra-analytical phase to secure quality assurance of the diagnostic tests for CDI.
Methods
We analyzed the volume and pattern of requested C. difficile - related tests from patients in 2018. The culture-positive rate was compared with the stool quality. Finally, the clinical characteristics of antibiotic-related diarrhea were compared based on whether toxigenic C. difficile was isolated.
Results
Culture plus toxin enzyme immunoassay was the most common pattern; however, it showed low positive rates for toxigenic C. difficile . The culture-positive rates were not different according to the Bristol stool form scale. The significant risk factors for the detection of toxigenic C. difficile in patients with antibiotic-associated diarrhea were inhibitor-combined penicillin or cephalosporin (odds ratio [OR], 5.060; 95% confidence interval [CI], 1.317–19.447; P =0.0183) and extended-spectrum cephalosporin (OR, 16.224; 95% CI, 3.166–83.134; P =0.0008).
Conclusions
The pre-pre-analytical errors are easy to overlook in routine laboratory procedures. Our findings could provide a good example of the management of the extra-analytical phase to secure quality assurance of the diagnostic tests for CDI.

Keyword

Clostridioides difficile; Diagnostic stewardship; Pre-pre-analytical error
Full Text Links
  • LMQA
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2021 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr