Discordant Clostridioides difficile diagnostic assay and treatment practice: a cross-sectional study in a tertiary care hospital, Geneva, Switzerland

Objectives: To determine the proportion of patients who received a treatment for Clostridioides difficile infection (CDI) among those presenting a discordant Clostridioides difficile diagnostic assay and to identify patient characteristics associated with the decision to treat CDI.

Design: Cross-sectional study.

Setting: Monocentric study in a tertiary care hospital, Geneva, Switzerland

Participants: Among 4562 adult patients tested for C. difficile between March 2017 and March 2019, 208 patients with discordant tests’ results (positive nucleic acid amplification test [NAAT+]/negative enzyme immunoassay [EIA-]) were included.

Main outcome measures: Treatment for CDI.

Results: CDI treatment was administered in 147 (71%) cases. In multivariate analysis, an abdominal computed tomography scan with signs of colitis (OR 14.7; 95% CI 1.96-110.8) was the only factor associated with CDI treatment.

Conclusions: The proportion of NAAT+/EIA- patients who received treatment questio...