Clinical and economic impact of the introduction of a nucleic acid amplification assay for Clostridium difficile

摘要

The clinical outcomes and cost implications of a diagnostic shift from an EIA- to PCR-based assay for Clostridium difficile infection (CDI) have not been completely described in the literature. The impact of the PCR-based assay on the incidence and duration of CDI therapy was compared to the EIA assay for patients with a negative CDI diagnostic result. Secondary clinical and economic outcomes were also evaluated. Independent predictors of receipt of antibiotic therapy were assessed via logistic regression. 141 EIA and 140 PCR patients were included. Significantly more patients were started or continued on anti-CDI antibiotic therapy after a known negative assay result in the EIA group (26 patients vs. 8 patients, P?=?0.002). Duration of antibiotic therapy after a known negative result was significantly shorter in the PCR group (1 vs. 4?days, P?=?0.029) and a 23% reduction in the number of tests obtained per patient was observed (1.41?±?0.86 vs. 1.82?±?1.35, P?=?0.007). The over fourfold difference in per-test cost of the EIA assay ($8.33 vs. $42.86, P?