期刊
TRANSPLANTATION AND CELLULAR THERAPY
卷 27, 期 1, 页码 -出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.bbmt.2020.10.005
关键词
Clostridioides difficile; CDI; Computerized clinical decision support; Vancomycin; Vancomycin-resistant enterococcus; Diagnostic stewardship
Clostridioides difficile infection rates are higher in hospitalized hematopoietic stem cell transplantation (HSCT) recipients and patients with hematologic malignancy (HM) compared with the general population. Implementation of a computerized decision support tool led to a significant decrease in C difficile testing volume and laboratory identifications. Decision support tools can help reduce testing and detection rates in hospitalized patients.
Clostridioides difficile infection rates are higher in hospitalized hematopoietic stem cell transplantation (HSCT) recipients and patients with hematologic malignancy (HM) compared with the general population. This is related both to extensive exposure to antibiotics as well as to frequent and often prolonged hospitalization. In this population, with numerous potential causes of diarrhea, a subset of C difficile detected is presumed to represent colonization rather than clinical infection. The use of decision support tools to guide ordering in hospitalized patients has been reported to decrease both C difficile testing and detection rates. Following implementation of a computerized decision support tool on our HSCT/HM unit, we observed a >2-fold decrease in C difficile testing volume and National Healthcare Safety Network-defined laboratory identifications of C difficile. Furthermore, the rate of oral vancomycin use, as well as the incidence of vancomycin-resistant enterococci colonization and bloodstream infection, decreased in the postintervention period. (C) 2020 The American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc. All rights reserved.
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