Evidence map›Paper›PMID 38352983›Full record

ArticlePediatrics2024

A Multimodal Intervention to Reduce C. difficile Infections and Stool Testing.

Jillian M Cotter, Claire L Stokes, Suhong Tong, Meghan Birkholz, Jason Child, Carrye Cost, Rebecca Coughlin, Stephanie Cox, Susan A Dolan, Kathleen Dorris and 5 more

Open access · greenAbstract read
In one paragraph

Article in Pediatrics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.6field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Acute infectious gastroenteritis in childhood: the role of rapid multiplex molecular syndromic panels in diagnosis and clinical management.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2025
    Review
  3. Three stages of laboratory stewardship in improving appropriateAntimicrobial stewardship & healthcare epidemiology : ASHE · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 3 institutions in 1 country.

Jillian M Cotter *Department of Pediatrics, University of Colorado, Aurora, Colorado.
Claire L Stokes *Department of Pediatrics, University of Colorado, Aurora, Colorado.
Suhong TongDepartment of Pediatrics, University of Colorado, Aurora, Colorado.
Meghan BirkholzDepartment of Pediatrics, University of Colorado, Aurora, Colorado.
Jason ChildChildren's Hospital Colorado, Aurora, Colorado.
Carrye CostDepartment of Pediatrics, University of Colorado, Aurora, Colorado.
Rebecca CoughlinChildren's Hospital Colorado, Aurora, Colorado.
Stephanie CoxDepartment of Pediatrics, University of Colorado, Aurora, Colorado.
Susan A DolanChildren's Hospital Colorado, Aurora, Colorado.
Kathleen DorrisDepartment of Pediatrics, University of Colorado, Aurora, Colorado.
Keith Z HazletonDepartment of Pediatrics, University of Colorado, Aurora, Colorado.
Virginia LugoChildren's Hospital Colorado, Aurora, Colorado.
Mikayla NorcrossChildren's Hospital Colorado, Aurora, Colorado.
Kelly PearceChildren's Hospital Colorado, Aurora, Colorado.
Samuel R DominguezDepartment of Pediatrics, University of Colorado, Aurora, Colorado.
Children's Hospital Colorado · USUniversity of Colorado Denver · USUniversity of Colorado Anschutz Medical Campus · US

Funding

Colorado Clinical and Translational Sciences Institute (CCTSI)UM1TR004399 · NCATS · UNIVERSITY OF COLORADO DENVER · PI JANINE A HIGGINS, RONALD J. SOKOL · 2023 to 2026
$30.7M
CTSA K12 Program at University of Colorado DenverK12TR004412 · NCATS · UNIVERSITY OF COLORADO DENVER · PI ELLEN L BURNHAM · 2024 to 2026
$3.2M
NCATS NIH HHS K12 TR004412NCATS NIH HHS UM1 TR004399
6 · The paper itself

Abstract

BACKGROUND AND

objectivesThe introduction of multiplex gastrointestinal panels at our institution resulted in increased Clostridioides difficile (C. difficile) detection and stool test utilization. We aimed to reduce hospital-onset C. difficile infections (HO-CDIs), C. difficile detection, and overall stool testing by 20% within 1 year.

methodsWe conducted a quality improvement project from 2018 to 2020 at a large children's hospital. Interventions included development of a C. difficile testing and treatment clinical care pathway, new options for gastrointestinal panel testing with or without C. difficile (results were suppressed if not ordered), clinical decision support tool to restrict testing, and targeted prevention efforts. Outcomes included the rate of HO-CDI (primary), C. difficile detection, and overall stool testing. All measures were evaluated monthly among hospitalized children per 10 000 patient-days (PDs) using statistical process-control charts. For balancing measures, we tracked suppressed C. difficile results that were released during real-time monitoring because of concern for true infection and C. difficile-related adverse events.

resultsHO-CDI decreased by 55%, from 11 to 5 per 10 000 PDs. C. difficile detection decreased by 44%, from 18 to 10 per 10 000 PDs, and overall test utilization decreased by 29%, from 99 to 70 per 10 000 PDs. The decrease in stool tests resulted in annual savings of $55 649. Only 2.3% of initially suppressed positive C. difficile results were released, and no patients had adverse events.

conclusionsDiagnostic stewardship strategies, coupled with an evidence-based clinical care pathway, can be used to decrease C. difficile and improve overall test utilization.

Indexed as

Clostridioides difficileClostridium InfectionsChildChild, HospitalizedCritical PathwaysHospitals, PediatricHumans

Identifiers

PMID38352983
PMCPMC11360068
OpenAlexW4391816151

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.