CDI: how to address a crucial diagnostic conundrum

As the most common cause of healthcare-associated diarrhoea in industrialised countries, Clostridium difficile continues to represent a significant amount of morbidity and mortality worldwide.¹ With each case of hospital-acquired C. difficile Infection (CDI) costing an estimated £7000 in the UK,² at a time of increased healthcare pressures and cost justifications, accurate testing for CDI is often high on hospital agendas.

Given the complex and persistent nature of CDI, testing methods and workflows can vary in different countries and even within different healthcare settings. This was evidenced in the EUCLID study that discovered that just two-fifths of hospitals across Europe were using optimal testing algorithms, as outlined in guidance, and there was a 40-fold variation in the frequency of testing.³ Critically, the variation in testing algorithms demonstrated the tangible risk of undiagnosed C. difficile, which, when extrapolated, was estimated to be a concerning 40,000 in-patients each year within 482 European hospitals.³

In recent times, however, as diagnostic capabilities have been developed and assessed in line with clinical outcome, we seem to be creeping closer to common algorithms that truly improve patient outcomes, inform treatment therapy and limit the unnecessary use of healthcare resources. This can have a significant impact on patients and the internal stakeholders involved with the CDI pathway, especially at a time of increased strain on healthcare services.