Estimating the effect of active detection and isolation on Clostridioides difficile infections in a bone marrow transplant unit

Kelly A Reagan; David M Chan; Ginger Vanhoozer; Gonzalo Bearman

doi:10.1017/ice.2023.37

Estimating the effect of active detection and isolation on Clostridioides difficile infections in a bone marrow transplant unit

Infect Control Hosp Epidemiol. 2023 Oct;44(10):1614-1619. doi: 10.1017/ice.2023.37. Epub 2023 Mar 13.

Authors

Kelly A Reagan¹, David M Chan¹, Ginger Vanhoozer², Gonzalo Bearman²

Affiliations

¹ Department of Mathematics and Applied Mathematics, Virginia Commonwealth University, Richmond, Virginia.
² Division of Infectious Diseases, Virginia Commonwealth University, Richmond, Virginia.

Abstract

Objective: To model the effects of active detection and isolation (ADI) regarding Clostridioides difficile infection (CDI) in the bone marrow transplant (BMT) unit of our hospital.

Setting: ADI was implemented in a 21-patient bone marrow unit.

Patients: Patients were bone marrow recipients on this unit.

Interventions: We compared active ADI, in which patients who tested positive for colonization of C. difficile before their hospital stay were placed under extra contact precautions, with cases not under ADI.

Results: Within the BMT unit, ADI reduced total cases of CDI by 24.5% per year and reduced hospital-acquired cases by ∼84%. The results from our simulations also suggest that ADI can save ∼$67,600 per year in healthcare costs.

Conclusions: Institutions with active BMT units should consider implementing ADI.

MeSH terms

Bone Marrow Transplantation / adverse effects
Clostridioides difficile* / isolation & purification
Clostridium Infections* / diagnosis
Clostridium Infections* / epidemiology
Cross Infection* / diagnosis
Cross Infection* / epidemiology
Hospital Units
Humans
Infection Control / methods