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Updated: Feb 13, 2026
09:12
A Protein Microarray Assay for Serological Determination of Antigen-specific Antibody Responses Following Clostridium difficile Infection
Published on: June 15, 2018
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Repeat stool testing to diagnose Clostridium difficile infection using enzyme immunoassay does not increase
Abhishek Deshpande1, Vinay Pasupuleti, Preethi Patel
1Department of Neurological Surgery, Neurological Institute, Cleveland Clinic, Ohio, USA. deshpaa@ccf.org
Summary
Repeat stool testing for Clostridium difficile infection (CDI) offers minimal diagnostic benefit. A single enzyme immunoassay (EIA) accurately diagnoses most cases, making routine repeat testing unnecessary for improved CDI detection.
Area of Science:
- Infectious Diseases
- Clinical Diagnostics
- Microbiology
Background:
- Clostridium difficile infection (CDI) is a growing concern in healthcare settings.
- Enzyme immunoassay (EIA) for toxins A and B is the standard diagnostic method.
- Current practice often involves testing multiple stool samples per patient.
Purpose of the Study:
- To evaluate the diagnostic yield of repeat stool sample testing for CDI.
- To determine if serial testing significantly increases CDI detection rates compared to a single test.
Main Methods:
- Retrospective analysis of 39,402 stool samples from 17,971 patients (2005-2008).
- Utilized enzyme immunoassay (EIA) for Clostridium difficile toxins A and B.
- Calculated transition probabilities for positive results across consecutive tests.
Main Results:
- 9.17% of diarrheal episodes were diagnosed with CDI.
- A single stool sample detected 90.7% of CDI cases.
- Repeat testing (2nd and 3rd samples) identified only an additional 8.6% of CDI cases.
Conclusions:
- Single stool EIA testing is highly effective, diagnosing nearly 91% of CDI cases.
- Routine repeat stool testing provides minimal additional diagnostic value for CDI.
- Recommendations suggest against routine repeat testing to optimize diagnostic efficiency.
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