HAI Diagnostic Testing Strategies in Pediatric Healthcare

Thomas Sandora, MD, MPH, hospital epidemiologist at Boston Children’s Hospital, discusses some up and coming pediatric healthcare associated infection prevention strategies.

Interview Transcript (slightly modified for readability).

“[There are some prevention strategies] on the horizon that are really exciting.

One relates to diagnostic testing, so a good example is [Clostridium] difficile infection, which is a bacterial infection in the intestine that you can get after you’ve been exposed to antibiotics and can cause diarrhea. It’s difficult to test children for C. diff because they carry this [bacterium] in their intestines when they’re very young, even if it’s not causing any symptoms. So, using the current tests we have, it’s hard to tell who’s just carrying it and who actually has it as a cause of diarrhea.

There’s a new ultrasensitive test that’s being developed that tells you the amount of toxins that [are] present and we’re currently doing some research to try to determine if we can use those toxin levels to distinguish children who are just carrying the bacteria versus those who actually have diarrhea related to it. Some of these new diagnostic tests that are especially important for young children I think are going to help us in targeting treatment of disease appropriately.

Another area is something we call antimicrobial stewardship, which is overseeing the use of antibiotics and making sure that antibiotics are used appropriately [as well as] not using them when you don’t need them. This is a really important area for pediatrics because especially in outpatient clinics. At your general pediatrician’s office, there are so many visits for fever and for diseases that might be infections and kids get antibiotics a lot of times for viruses and for other scenarios where antibiotics don’t help. So, there’s a big emphasis on antibiotic stewardship and teaching outpatient providers about how to appropriately target when antibiotics are needed and when they won’t be helpful. I think that that’s going to make a big difference [in reducing] antibiotic resistant bacteria, which are becoming more and more of a problem.”