866 infection control & hospital epidemiology july 2018, vol. 39, no. 7
differ somewhat from prior studies where GDH screening was not performed. Our study has potential limitations. First, given the relatively
limited sample size available for clinical outcomes, we were unable to perform a multivariable analysis for the association between C. difficile testing method and patient outcomes. Additionally, our study focused on the care of hematology oncology patients at an academic institution and may not be generalizable to populations with different characteristics. In conclusion, our findings highlight the importance of
evaluating the characteristics and performance of C. difficile testing algorithms specifically in high-risk populations. Additionally, considering the high morbidity and mortality associated with C. difficile in this population, future studies are needed focusing on optimal methods of differentiating colonization versus infection, as well as preventing C. difficile disease in patients with hematologic malignancy.11
acknowledgments
Financial support: This work was supported by the National Institutes of Health (grant no. T32-AI055435 to M.Z. and grant no. K01-AI103028 to J.H.H.) and by a CDC Cooperative Agreement, FOA#CK16-004-Epicenters for the Preven- tion of Healthcare Associated Infections. The funding agencies had no role in the design and conduct of the study; collection, management, analysis, and inter- pretation of the data; or preparation, review, or approval of the manuscript. Potential conflicts of interest: All authors report no conflicts of interest relevant to this study.
Affiliations: 1. Division of Infectious Diseases, Department of Healthcare Epidemiology, Infection Prevention and Control Perelman School of Medi- cine, University of Pennsylvania, Philadelphia, Pennsylvania; 2. Division of Hematology and Oncology, Department of Healthcare Epidemiology, Perel- man School of Medicine, University of Pennsylvania, Philadelphia, Pennsyl- vania; 3. Department of Healthcare Epidemiology, Infection Prevention and Control Perelman School of Medicine, University of Pennsylvania, Philadel- phia, Pennsylvania; 4. Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; 5. Center for Clinical Epidemiology and Biostatistics, Perel- man School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania. Address correspondence to Matthew Ziegler, MD, 3400 Spruce St, 3 Sil-
verstein, Suite E Philadelphia, PA 19104 (
matthew.ziegler@uphs.upenn.edu). PREVIOUS PRESENTATION. The interim results of this study were presented at the Infectious Disease Society of America IDWeek as a poster (Presentation #1291) on October 6th, in San Diego, California.
Received October 18, 2017; accepted March 10, 2018; electronically published April 25, 2018 © 2018 by The Society for Healthcare Epidemiology of America. All rights reserved. 0899-823X/2018/3907-0015. DOI: 10.1017/ice.2018.83
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