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

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

Kelly A Reagan  1 , David M Chan  1 , Ginger Vanhoozer  2 , Gonzalo Bearman  2
Affiliations

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

Kelly A Reagan et al. Infect Control Hosp Epidemiol. 2023 Oct.

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.

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Conflict of interest statement

All authors report no conflicts of interest relevant to this article.

Figures

Fig. 1.
Fig. 1.
Model diagram for non-ADI model with patient states. Note. susceptible, S, susceptible on antibiotics, S A , asymptomatic colonization by environment, C H , asymptomatic colonization by antibiotics, C A , admitted with asymptomatic colonization, C N , infectious, not screened yet, I N , infectious, screened, I S , and recovered, R. The arrows indicate a probability of transitioning to the next class.
Fig. 2.
Fig. 2.
Model diagram for ADI-model when ADI is implemented. The differences between the non-ADI model and the ADI model are highlighted in gold.
Fig. 3.
Fig. 3.
Monthly C. difficile data from VCU Medical Center BMT unit from February 2014 to December 2019. The bars represent the monthly cases; the thick red line represents the overall average number of cases; and the red box represents 1 standard deviation above and below the mean.
Fig. 4.
Fig. 4.
Simulated monthly data with non-ADI model. The blue bars represent the monthly cases; the thick red line represents the overall average number of cases; and the red box represents 1 standard deviation above and below the mean.
Fig. 5.
Fig. 5.
Simulated monthly data with ADI model. The red bars represent the monthly cases; the thick blue line represents the overall average number of cases; and the blue box represents 1 standard deviation above and below the mean.
See this image and copyright information in PMC

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