CDI-specific Follow-up Visits Rare among Patients Hospitalized for Recurrence

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Recurrent Clostridioides difficile infection (rCDI) is common, yet new research reveals that the majority of patients rehospitalized for the infection did not have a confirmed CDI-specific follow-up appointment within 30 days of original hospital discharge.

The study abstract was presented at IDWeek 2021, being held virtually, September 29 – October 3, 2021.

“CDI is notorious for causing recurrent illness and potentially resulting in rehospitalization,” wrote study authors led by Emily Drwiega, PharmD, an infectious diseases pharmacy fellow at the University of Illinois at Chicago. The researchers emphasize that both hospital-acquired infections and readmissions are red flags for the Centers for Medicare & Medicaid Services, and reducing their rates could help tamp down health care spending.

Drwiega and colleagues conducted a single-center retrospective chart review to determine the frequency of follow-up appointments among patients with CDI and rates of rehospitalization in patients with rCDI. Electronic medical records were reviewed for all hospitalized patients with a positive stool test for C. difficile from January through June 2018.

There were 283 patients with a C. difficile diagnosis made by a treating physician. Mean age was 64 years, half were men, approximately 70% were White and approximately 20% Black. Of the total group, 211 were diagnosed with primary CDI, 29 with rCDI, and 43 with CDI colonization; 43% were designated as immunocompromised.

Drwiega et al identified a confirmed follow-up appointment within 30 days of hospital discharge for only 14.8% of patients. They report the rate of 30-day post-discharge follow-up appointments for patients who developed rCDI within 90 days after hospitalization was only slightly higher, at 18.5%.

Among the patients with rCDI, researchers found that close to half (44%) were rehospitalized for their recurrence. Prior to rehospitalization for rCDI, only 2 of those admitted had been seen for a follow-up appointment.

The authors conclude, “Further study is necessary to determine whether a dedicated follow-up appointment, specifically for CDI, would result in decreased rehospitalizations associated with rCDI.”

Source: Drwiega EN, Danziger LH, Johnson S, et al. Readmissions of hospitalized patients with Clostridioides difficile infection (CDI) for recurrent CDI is common. Poster 766 presented at IDWeek 2021 Virtual Conference; held online September 29 - October 3, 2021.