Artificial Differences in Clostridium difficile Infection Rates Associated with Disparity in Testing
, Jennifer Brite, Anoshe Aslam, Jessica Kennington, N. Esther Babady, David Calfee, Yoko Furuya, Donald Chen, Michael Augenbraun, Belinda Ostrowsky, Gopi Patel, Monica Mircescu, Vivek Kak, Roman Tuma, Teresa A. Karre, Deborah A. Fry, Yola P. Duhaney, Amber Moyer, Denise Mitchell, Sherry Cantu, Candace Hsieh, Nancy Warren, Stacy Martin, Jill Willson, Jeanne Dickman, Julie Knight, Kim Delahanty, Annemarie Flood, Jennifer Harrington, Deborah Korenstein, Janet Eagan, and Kent Sepkowitz
Author affiliations: Memorial Sloan Kettering Cancer Center, New York, New York, USA (M. Kamboj, J. Brite, A. Aslam, J. Kennington, N.E. Babady, D. Korenstein, J. Eagan, K. Sepkowitz); New York-Presbyterian/Weill Cornell Medical Center, New York (D. Calfee); Columbia University Medical Center, New York (Y. Furuya); Westchester Medical Center, Westchester, New York, USA (D. Chen); University of Brooklyn, Brooklyn, New York, USA (M. Augenbraun); Montefiore Medical Center, New York (B. Ostrowsky); Mount Sinai Hospital, New York (G. Patel); St. Joseph Medical Center, Phoenix, Arizona, USA (M. Mircescu); Henry Ford Allegiance Health, Jackson, Mississippi, USA (V. Kak); Easton Hospital, Easton, Pennsylvania, USA (R. Tuma); Methodist Hospital, Omaha, Nebraska, USA (T.A. Karre); Lehigh Valley Health Network, Allentown, Pennsylvania, USA (D.A. Fry); South Miami Hospital, Miami, Florida, USA (Y.P. Duhaney); Hartford Hospital, Hartford, Connecticut, USA (A. Moyer, D. Mitchell); Backus Hospital, Norwich, Connecticut, USA (A. Moyer, D. Mitchell); Windham Hospital, Willimantic, Connecticut, USA (A. Moyer, D. Mitchell); Mid State Medical Center, Meriden, Connecticut, USA (A. Moyer, D. Mitchell); Hospital of Central Connecticut, New Britain, Connecticut, USA (A. Moyer, D. Mitchell); MD Anderson Cancer Center, Houston, Texas, USA (S. Cantu); Dana Farber Cancer Institute, Boston, Massachusetts, USA (C. Hsieh); Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA (N. Warren); Moffitt Cancer Center, Tampa, Florida, USA (S. Martin); University of Southern California Norris Comprehensive Cancer Center, Los Angeles, California, USA (J. Willson); James Cancer Center, Columbus, Ohio, USA (J. Dickman); Seattle Cancer Care Alliance, Seattle, Washington, USA (J. Knight); University of California San Diego Hospital, San Diego, California, USA (K. Delahanty); City of Hope, Duarte, California, USA (A. Flood); Roswell Park, Buffalo, New York, USA (J. Harrington)
Figure 2. Correlation between HO-CDI rates (per 1,000 patient-days) and standardized testing volume (A,B), average length of hospital stay (C), number of hospital beds (D), and diagnostic test used (E), 30 US hospitals, 2015. Yellow indicates community hospitals; blue, multispecialty academic centers; gray, tertiary care cancer centers. p values and Pearson coefficient (r) values are as follows: A) p<0.001, r = 0.29. B) p = 0.0014, r = 0.57. C) p = 0.0003, r = 0.68. D) p = 0.1276, r = –0.29. EIA, enzyme immunoassay; HO-CDI, hospital-onset C. difficile infection; NAAT, nucleic acid amplification testing.
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