Decreasing Treatment for Postoperative Clostridioides difficile Infection in Pediatric Surgery Patients.
In-house automatic confirmatory testing cut postoperative C difficile treatment rate to 0.07%.
Decreasing Treatment for Postoperative Clostridioides difficile Infection in Pediatric Surgery Patients.
Our hospital was an outlier for postoperative Clostridioides difficile infection (clostridioides difficile infection) on the 01/2022 NSQIP-Pediatric Semiannual Report.
Surgical patients eligible for NSQIP-Pediatric sampling from 01/2022-07/2025 were analyzed to identify patients treated for clostridioides difficile infection within 30 days of surgery.
Only 0.07% of surgical patients were treated for C difficile after this testing change.
We identified 16,926 NSQIP-Pediatric eligible patients, and 55 were treated for clostridioides difficile infection.
Ten patients (18%) were treated despite negative confirmatory testing.
With education, confirmatory testing decreased from 82% to 62%, but clostridioides difficile infection treatment decreased from 0.58% to 0.26% over the first 18 months.
Confirmatory cytotoxin testing in an in-house automatic fashion allows accurate treatment of patients with active clostridioides difficile infection instead of colonization.
Utilization of a QI tool focused on diagnostic and antibiotic stewardship can successfully decrease system-wide healthcare resource utilization and costs, while improving patient care.
Reducing inappropriate treatment of colonized patients lowered the NSQIP-P-defined clostridioides difficile infection rate without an increase in missed or delayed diagnoses, fulminant clostridioides difficile infection, or clostridioides difficile infection requiring surgery.