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Optimizing the diagnostic testing of Clostridium difficile infection.

Emilio Bouza1,2,3,4, Luis Alcalá1,4, Elena Reigadas1,3

  • 1a Department of Clinical Microbiology and Infectious Diseases , Hospital General Universitario Gregorio Marañón , Madrid , Spain.

Expert Review of Anti-Infective Therapy
|July 28, 2016
PubMed
Summary

Clostridium difficile infection (CDI) diagnosis requires prompt laboratory testing for C. difficile toxins in diarrheal samples from patients over 2 years old. Nucleic acid assay techniques (NAAT) offer faster results for improved patient care.

Keywords:
Clostridium difficilecell cytotoxicity assaydiagnostic algorithmsenzyme immune assaylaboratory diagnosisnucleic acid amplification teststoxigenic culture

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Area of Science:

  • Microbiology
  • Infectious Diseases
  • Clinical Diagnostics

Background:

  • Clostridium difficile infection (CDI) is a major cause of hospital-acquired diarrhea.
  • Significant health and economic burdens are associated with CDI.
  • Current laboratory diagnostic approaches for CDI lack consensus, leading to varied testing strategies.

Purpose of the Study:

  • To review practical aspects of CDI laboratory diagnosis.
  • To provide expert recommendations for optimizing CDI diagnostic strategies.

Main Methods:

  • Review of current literature and expert opinion on CDI diagnostics.
  • Analysis of different laboratory testing methodologies for C. difficile.

Main Results:

  • Recommends testing all fecal diarrheic samples from patients > 2 years old for C. difficile toxins.
  • Direct toxin detection or isolation of C. difficile from cultures confirms CDI.
  • Nucleic Acid Assay techniques (NAAT) expedite diagnosis and impact treatment and epidemiology.

Conclusions:

  • Standardized laboratory testing for C. difficile toxins is crucial for accurate CDI diagnosis.
  • Optimized diagnostic strategies, including NAAT, can improve patient outcomes and infection control.