Impact of a Clostridioides Difficile Testing Computerized Clinical Decision Support Tool on an Adult Stem Cell Transplantation and Hematologic Malignancies Unit.

Autor: Nix CD; Department of Infection Prevention and Control, Oregon Health & Science University, Portland, Oregon., Messer WB; Division of Infectious Diseases, Department of Medicine, Oregon Health & Science University, Portland, Oregon; Department of Molecular Microbiology and Immunology, Oregon Health & Science University, Portland, Oregon; Program in Epidemiology, Oregon Health & Science University-Portland State University School of Public Health, Portland, Oregon., Hale ML; Department of Infection Prevention and Control, Oregon Health & Science University, Portland, Oregon., Lewis JS 2nd; Department of Pharmacy Services, Oregon Health & Science University, Portland, Oregon., Strasfeld LM; Division of Infectious Diseases, Department of Medicine, Oregon Health & Science University, Portland, Oregon. Electronic address: strasfel@ohsu.edu.
Jazyk: angličtina
Zdroj: Transplantation and cellular therapy [Transplant Cell Ther] 2021 Jan; Vol. 27 (1), pp. 94.e1-94.e5. Date of Electronic Publication: 2020 Oct 09.
DOI: 10.1016/j.bbmt.2020.10.005
Abstrakt: 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.
(Copyright © 2020 American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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