Detection and characterization of <i>Clostridium difficile</i> infections tracking the trends of <i>Clostridium difficile</i> culture

Ock, Min-Su; Oh, Jin-Sun; Kim, Hwa-Jung; Lyu, Yong-Man; Lee, Moo-Song

doi:2016.22.2.15

Qual Improv Health Care > Volume 22(2); 2016 > Article

Original Article

Quality Improvement in Health Care 2016;22(2): 15-25.
DOI: https://doi.org/10.14371/QIH.2016.22.2.15 Published online December 30, 2016.

Detection and characterization of Clostridium difficile infections tracking the trends of Clostridium difficile culture

Min-Su Ock¹, Jin-Sun Oh², Hwa-Jung Kim³, Yong-Man Lyu⁴, Moo-Song Lee^1,3

¹Department of Preventive Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
²Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
³Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
⁴Office of Clinical Research Information, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

Correspondence Moo-Song Lee ,Tel: +82-2-3010-4285, Fax: +82-2-477-2898, Email: leems@amc.seoul.kr

Received: November 2, 2016 Revised: December 14, 2016 Accepted: December 21, 2016

Abstract

Objectives
In this study, we examined the validity of Clostridium difficile culture results as a proxy measure of Clostridium difficile infection, and inferred the epidemiologic characteristics of Clostridium difficile infection by tracking the trends of Clostridium difficile culture results.
Methods
We reviewed the medical records to figure out the actual possibilities of Clostridium difficile infection of those with positive or negative results of Clostridium difficile culture during the time span from January 2012 to March 2012. We calculated the positive and negative predictive value of Clostridium difficile culture results for Clostridium difficile infection. Furthermore, epidemiologic characteristics of Clostridium difficile infection in a tertiary general hospital in 2012 were analyzed.
Result
The estimated positive predictive value of Clostridium difficile culture tests for Clostridium difficile infection was 100%, and the estimated negative predictive value was around 94.4~99.3% depending on the cutoff value of possibility of Clostridium difficile infection. A total of 622 cases were identified as Clostridium difficile infection in a tertiary general hospital in 2012 and there were 4.9 patients with Clostridium difficile infection per 1,000 inpatients.
Conclusion
In conclusion, we identified that Clostridium difficile culture results can be used as a proxy measure of Clostridium difficile infection.

Key words Clostridium difficile infection, Patient safety indicator, Medical record review