In recent quality improvement studies, hospitals implementing the Centers for Disease Control and Prevention (CDC) Strategies Framework for preventing hospital-onset Clostridioides difficile infection (HO-CDI) exhibited a more rapid reduction in incidence compared to those that didn’t. However, it was determined that the effectiveness of the Framework could not conclusively be credited for this decrease. The 20 hospitals that participated in the Framework showed a steeper decline in HO-CDI incidence versus the 26 non-participating hospitals. However, it’s important to note that this decline appeared not to be associated directly with the implementation of the Framework.
This suggests that further research is needed to clearly determine the Framework’s exact impact. Indeed, the incidence of HO-CDI was already on a downward trend in participating hospitals prior to the intervention, and this rate of decline did not change during the period the Framework was being implemented. The integral features of the CDC Strategies Framework to prevent Clostridioides difficile infection in acute care facilities comprise 39 categories of interventions within five focus areas. Despite the Framework’s foundation on evidence-based recommendations, no clinical studies have been conducted to date to assess the effectiveness of these recommendations. In this particular study, comparisons were made between the temporal trends of HO-CDI incidence in both intervention hospitals and non-intervention, control hospitals.
Cases of CDI were identified using a toxin A/B assay or nucleic acid amplification from stool samples and were determined to be hospital onset if occurring after the third day of hospitalization. Notably, although the baseline pattern of decreasing incidence complicated the analysis of the Framework effect, the intervention hospitals still exhibited a steeper decline in HO-CDI incidence over time relative to the control hospitals. This finding indicates that the degree to which hospitals implemented the Framework was linked with steeper declines in HO-CDI incidence. However, the baseline rate of decline did not change with the implementation of the Framework strategies. A few interventions identified as particularly beneficial included case reviews to identify areas for improvement, stewardship interventions targeting antibiotics with a high risk of CDI, and the utilization of two-step testing methods.
Source: https://www.contagionlive.com/view/cdc-strategies-tested-for-preventing-hospital-onset-c-difficile