Intestinal Research

Original Article

Infection

The impact of the quality improvement program on Clostridioides difficile infection management: a quasi-experimental study: Jung Yun Lee, Jae-Ki Choi, Tae-Geun Gweon, Young Eun An, Hyo Suk Kim, Jae Hyuck Chang, Tae Ho Kim, Chang Whan Kim, Young-Seok Cho; Intest Res 2025;23(4):551-558. Published online October 28, 2025; DOI: https://doi.org/10.5217/ir.2025.00137

Abstract PDF PubReader ePub: Background/Aims
Clostridioides difficile infection (CDI) is a major cause of nosocomial diarrhea. This study aimed to implement a quality improvement program to expedite proper CDI treatment, including discontinuing laxatives and associated antibiotics.
Methods
Stool test results positive for CDI were automatically sent via text message to the quality improvement team, specialists in CDI management. The quality improvement team played an advisory role in this treatment. The outcome of this study was the competency of CDI treatment within 24 hours of stool test reporting. Competency was investigated using 3 different models: Model 1, initiation of CDI treatment within 24 hours of positive stool test report; Model 2, Model 1 criteria met with no concurrent laxative use; and Model 3, Model 2 criteria met with no concurrent associated antibiotics. Competency rates were compared between pre- and post-intervention periods (1 year each). Analyses were performed for inpatients with CDI.
Results
In total, 310 inpatients with CDI (129 pre-intervention, 181 post-intervention) were included in this study. The rates of competency for Model 1 (85.3% vs. 95.6%, p= 0.006), Model 2 (81.4% vs. 92.3%, p= 0.004), and Model 3 (35.7% vs. 56.4%, p< 0.001) in the post-intervention group were higher to those in the pre-intervention group.
Conclusions
Quality improvement program enhanced the quality of CDI treatment in terms of prompt treatment and discontinuation of concomitant laxatives and associated antibiotics. (cris.nih.go.kr; KCT0005892)

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Case Report

A Case of Abdominal Actinomycosis Presenting as Ileocecal Ulcers and Recurrent Lower Gastrointestinal Bleeding: Jin Young Park, Sok Won Han, Chang Whan Kim, Tae Ho Kim, Jae Hyuck Chang, Il Ho Maeng, Mi Jeong Lee, Yun Sun Im, Ji Hun Kim, Sung Min Nam; Intest Res 2012;10(3):309-313. Published online July 31, 2012; DOI: https://doi.org/10.5217/ir.2012.10.3.309

Abstract PDF: Abdominal actinomycosis is a rare chronic suppurative infection that is difficult to diagnose precisely without an operation. It also tends to be misdiagnosed as a malignancy, intestinal tuberculosis, diverticular disease, or Crohn's disease. A 54-year-old man presented with loose stools, hematochezia, and vague abdominal pain in the right lower quadrant. He had had a history of hematochezia and recurrent colon ulcers on colonoscopy seven times within the past 3 years. A colonoscopy at admission revealed multiple, variably sized and shaped ulcerations in the terminal ileum, cecum, and ascending and transverse colons. Biopsies from the cecal ulcer demonstrated sulfur granules. This is the first cases of abdominal actinomycosis presenting as a recurrent lower gastrointestinal hemorrhage due to ileocolic ulcerations in Korea. (Intest Res 2012;10: 0-313)

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