Data from the National Healthcare Safety Network (NHSN) demonstrates that changing C. difficile test method alone will not decrease a facility’s standardized infection ratio (SIR). Test method is reflected in both the numerator and denominator of the equation used to calculate SIR, effectively compensating for differences in sensitivity between common test methods.
Impact on switching from PCR to a less sensitive test:
– Lowers the number of observed CDI events (numerator of SIR) but also decreases the predicted number of CDI events (denominator of SIR) proportionately (NHSN applies a negative adjustment factor to compensate for decreased test sensitivity)
– May result in true cases of CDI being missed due to reduced sensitivity (Disease may spread)
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