CDI Prevention Protocols Maddeningly Inconsistent
In response to a follow-up question about whether interventions and surveillance had resulted in a decline in healthcare facility onset or associated C. diff rates, only 42%% said there had been a decline, but 43% said there had not. And 15% said they didn't know.
There are many more examples of strategy variation. But before I go on, you should know that this "Pace of Progress" survey was designed by members of the well-regarded Association for Professionals in Infection Control and Epidemiology, which sent it to its 14,000 members.
To be fair, only 1,087 professionals responded—just under 8%—which isn't that great. APIC officials are quick to acknowledge that this was not a rigorous scientific survey.
But it was a survey, and it was the first one the organization has done on C. diff practicesin three years. During that time, CDIs continued their rampage through healthcare settings.
According to a CDC report, between 2000 to 2009 the number of patients discharged from hospitals with any diagnosis of CDI more than doubled, from 139,000 to 336,000, even though incidence of other healthcare-associated infections had declined in that period.
The CDC estimates healthcare cost of hospital-onset C. diff infections to be $5,042 to $7,179 per case with a national annual estimate of $897 million to $1.3 billion.
Evidence for controlling infections "has been published," the CDC says, but it acknowledges a very real problem: The scientific underpinnings for that evidence are weak.
"The degree to which they can prevent CDIs effectively across a range of hospitals is unknown, as is the relative burden of CDIs in nonhospital and hospital healthcare settings," the CDC said in a "Vital Signs" report a year ago.
So for C. diff, it appears, it's still the wild, wild West.
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