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

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.

Screening for Asymptomatic Clostridioides difficile Carriage Among Hospitalized Patients: A Narrative Review

“…Mathematical modeling of C. difficile transmission and simulation of screening and isolation of carriers have shown the intervention required to effectively reduce CDI rates [ 60 – 63 ]. This intervention was also highly cost-effective, with estimates ranging between 128 and 310$ per quality-adjusted life year, or even less if screening was targeted to high-risk populations; under some conditions, screening might lead to cost savings per case averted [ 64 – 66 ].…”