Clostridioides difficile (C. difficile) Testing and Management

Clostridioides difficile is the most commonly recognized cause of infectious diarrhea in the healthcare setting. In this course, Jorge Murillo, M.D. and Alice Margulis, Pharm.D. discuss inpatient testing and clinical management via clinical case discussions.

This course is the result of interdisciplinary educational planning and delivery by the Antimicrobial Stewardship Clinical Program and Continuing Education Subcommittee.
 

Target Audience

Physicians, mid-level practitioners, nurses, nurse practitioners, physician assistants, pharmacists, pharmacy technicians, laboratory personnel (microbiology) and other healthcare professionals. 

Learning Objectives

  • Explain the prevalence, risk factors and clinical manifestations of Clostridioides difficile infection (CDI) and distinguish clinical scenarios when C. difficile testing is advisable.
  • Implement a multimodal approach to CDI management.
Additional information
Bibliography: 
  • McDonald, L. C., Gerding, D. N., Johnson, S., Bakken, J. S., Carroll, K. C., Coffin, S. E., ... & Loo, V. (2018). Clinical practice guidelines for Clostridium difficile infection in adults and children: 2017 update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA). Clinical Infectious Diseases, 66(7), e1-e48.
  • U.S. Centers for Disease Control and Prevention’(2019). Antibiotic Resistance Threats in the United States, 2019. U.S. Department of Health and Human Services. https://www.cdc.gov/drugresistance/pdf/threats-report/2019-ar-threats-report-508.pdf
  • Deshpande, A., Pasupuleti, V., Thota, P., Pant, C., Rolston, D. D., Sferra, T. J., ... & Donskey, C. J. (2013). Community-associated Clostridium difficile infection and antibiotics: a meta-analysis. Journal of Antimicrobial Chemotherapy, 68(9), 1951-1961.
  • See I, Mu Y, Cohen J, et al. NAP1 Strain Type Predicts Outcomes from Clostridium difficile Infection. Clinical Infectious Diseases. 2014; 58(10): 1394-1400.
  • Burdette SD, Bernstein JM. Does the Nose Know? The Odiferous Diagnosis of Clostridium difficile-Associated Diarrhea. Clinical Infectious Diseases. 2007; 44(8): 1142.
  • Rao K, Berland D, Young C, et al. The Nose Knows Not: Poor Predictive Value of Stool Sample Odor for Detection of Clostridium difficile. Clinical Infectious Diseases. 2013; 56(4): 615–616.
  • Bobenchik A. Battleground Zero: A Review of Best Practice Recommendations for Clostridioides (Clostridium) difficile Testing. Clinical Microbiology Newsletter. 2019; 41(20): 175–183.
  • Schuetz A. Diagnosis of C. difficile – Why So Difficult? The Journal of Applied Laboratory Medicine. 2018.
Course Summary
Available credit: 
  • 1.25 ABIM MOC II
  • 1.25 AMA PRA Category 1 Credit™
  • 1.25 General certificate of attendance
  • 1.20 Florida Board of Laboratory Personnel
  • 1.00 Nurse Practitioners
  • 1.00 Florida Board of Nursing
  • 1.25 Florida Board of Pharmacy
Course opens: 
06/01/2020
Course expires: 
05/31/2023

Alice Margulis, Pharm. D., BCIDP
Antimicrobial Stewardship Clinical Pharmacy Specialist
South Miami Hospital

Jorge Murillo, M.D., FIDSA, FACP
Infectious Diseases Physician

Antimicrobial Stewardship Continuing Education Subcommittee

Stacey Baker, M.D.
Infectious Diseases Specialist
Baptist, South Miami, Doctors Hospitals

Timothy P. Gauthier, Pharm.D., BCPS-AQ ID
Antimicrobial Stewardship Clinical Program Manager
Baptist Health South Florida

Richard Levine, M.D.
Infectious Diseases Specialist
Baptist, South Miami, Doctors Hospitals

Jorge Murillo, M.D.
Infectious Diseases Specialist
Baptist, South Miami, Doctors Hospitals

Stacey Baker, M.D., Timothy P. Gauthier, Pharm.D., BCPS-AQ ID, and Alice Margulis, Pharm. D., BCIDP, have no relevant financial relationships with ineligible companies* to disclose, and they will not include off-label or unapproved product usage in their presentation or discussion.

Richard Levine, M.D., subcommittee member, has no relevant financial relationships with ineligible companies* to disclose.

Jorge Murillo, M.D., subcommittee member, is on the speakers' bureau for Merck. All of the relevant financial relationships listed for this individual has been mitigated.

All other non-faculty contributors, subcommittee members, content reviewers and others involved in the planning, development and editing/review of the content have no relevant financial relationships to disclose with ineligible companies*.

 *Ineligible companies -- Companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

Disclosure Policy and Disclaimer

Baptist Health South Florida is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. Baptist Health has been re-surveyed by the ACCME and awarded Commendation for 6 years as a provider of CME for physicians.
              
Baptist Health South Florida designates this enduring material for a maximum of 1.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

American Board of Internal Medicine Maintenance of Certification

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.25 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

Your participation information will be shared with the ACCME, which will in turn report your points to ABIM. Successful completion of a course examination is required to earn ABIM MOC points.

NOTE: Maintenance of Certification (MOC) points will be automatically reported to the ABIM. Submissions are recorded in approximately 48 hours. You will receive an email when your credits have been processed.

Through an agreement between the Accreditation Council for Continuing Medical Education and the Royal College of Physicians and Surgeons of Canada, medical practitioners participating in the Royal College MOC Program may record completion of accredited activities registered under the ACCME’s “CME in Support of MOC” program in Section 3 of the Royal College’s MOC Program.

Available Credit

  • 1.25 ABIM MOC II
  • 1.25 AMA PRA Category 1 Credit™
  • 1.25 General certificate of attendance
  • 1.20 Florida Board of Laboratory Personnel
  • 1.00 Nurse Practitioners
  • 1.00 Florida Board of Nursing
  • 1.25 Florida Board of Pharmacy
Please login or register for a Baptist Health CME account to take this course.

NOTE: Maintenance of Certification (MOC) points will be automatically reported to the ABIM. Submissions are recorded in approximately 48 hours. You will receive an email when your credits have been processed.

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