Early identification of Clostridium Difficile patients in the Emergency Department: Observational study in acute care hospital in Sicily
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Resident physician university of catania hygiene and medicine preventive - arnas garibaldi, Italy
Hospital arnas garibaldi, Italy
Publication date: 2023-04-26
Popul. Med. 2023;5(Supplement):A1962
Backround and Objective:
Clostridioides Difficile Infection (CDI) is one of the most important healthcare-associated infections (HCAI) in industrialised countries, where C. difficile is the leading cause of diarrhoea in hospital settings. In the last few years, there has been an increase in the number of CDI cases and in the severity of these infections and the associated mortality, especially in elderly patients, with a consequent increase in the length of hospital stay and in direct and indirect healthcare costs. The aim of our study is to analyse the impact of early identification of Clostridoides difficile (CDI) in reducing healthcare-associated infections in different in-patient units during 2019 – 2022.

We revised all the requests received by “The Hospital Garibaldi Centro” - Clinical Pathology - from all operating units from January 2019 to November 2022, which refers to CDI. First, specimens were screened by a rapid chromatographic immunoassay for C. difficile glutamate dehydrogenase antigen (GDH) + Toxin A + Toxin B. Second, GDH- positive and toxin-negative specimens were subjected to real-time multiplex PCR assay.

199 CDI cases were identified out of 937 (21%). 54% were identified in the emergency unit, 18% in critical care medicine, 9% in internal medicine, 21% was identified in other operative units (Orthopaedics, Neurology, Neurosurgery, Pneumology, Cardiology, General Surgery, Intensive Care Units). The male/female ratio was 1:1; 55% were adults over 80 years, 24 % were in the ages 70 to 80 years, 13 % were in the ages 60 to 70 years, and the remaining 8 % were patients under 60 years.

The early identification of CDI in the emergency unit, following the implementation of the procedures drawn up by Hospital, made it possible to take the appropriate control measures and immediate action to limit its spread in the operative units.