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A Protocol to Characterize the Morphological Changes of Clostridium difficile in Response to Antibiotic Treatment
Published on: May 25, 2017
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Diagnostic testing for Clostridium difficile in Italian microbiological laboratories
Patrizia Spigaglia1, Fabrizio Barbanti1, Matteo Morandi2
1Department of Infectious, Parasitic and Immune-mediated Diseases, Istituto Superiore di Sanità, Rome, Italy.
Anaerobe
|November 12, 2015
Summary
A survey of Italian laboratories found that while most diagnose Clostridium difficile infection (CDI), diagnostic methods are inconsistent. Predominant C. difficile strains are multidrug-resistant, highlighting the need for improved laboratory practices and clinician awareness.
Area of Science:
- Microbiology
- Infectious Diseases
- Clinical Diagnostics
Background:
- Clostridium difficile infection (CDI) is a significant healthcare-associated infection.
- Laboratory diagnosis is crucial for effective CDI management.
- Variations in diagnostic practices can impact patient outcomes and surveillance.
Purpose of the Study:
- To assess the current state of laboratory diagnosis for CDI in Italy.
- To identify prevalent C. difficile strains and their antimicrobial resistance patterns.
- To evaluate adherence to European guidelines for CDI diagnosis.
Main Methods:
- A nationwide survey of 278 healthcare laboratories in Italy (2012-2013).
- Analysis of diagnostic methods used, including immunoenzymatic assays (EIA), molecular assays, and culture.
- PCR-ribotyping and antimicrobial susceptibility testing of collected C. difficile isolates.
Main Results:
- 87% of laboratories routinely diagnosed CDI, primarily upon clinician request.
- Immunoenzymatic assay (EIA) was the most common stand-alone method (42%); only 34% followed European guidelines.
- Predominant PCR-ribotypes (356/607 and 018) showed high multidrug resistance, particularly to moxifloxacin, rifampicin, erythromycin, and clindamycin.
Conclusions:
- Significant heterogeneity exists in CDI diagnostic methods across Italian laboratories.
- The prevalence of multidrug-resistant C. difficile strains necessitates standardized diagnostic approaches.
- Enhanced clinician awareness and harmonized laboratory practices are essential for effective CDI surveillance and control.
