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在患有传染性腹的患者中进行综合征面板测试:解释 Clostridioides difficile 的挑战多重分子面板上的阳性

Melissa Pender¹, S Kyle Throneberry², Nancy Grisel²

¹Division of Infectious Diseases, Department of Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA.

Open forum infectious diseases

|September 15, 2023

概括

在胃肠道面板上呈阳性Clostridioides difficilePCR结果是常见的,但毒素检测较少. 临床医生应仔细考虑预测概率,以避免对C. difficile感染进行不必要的抗生素治疗.

科学领域:

临床微生物学临床微生物学
传染病传染病传染病
胃肠病学胃肠病学

背景情况:

多重肠胃聚合酶连锁反应 (GIPCR) 面板可以检测Clostridioides difficile (CD).
没有预测概率 (PTP) 评估的偶然CD检测可能导致误诊和不必要的抗生素使用.

研究的目的:

为了评估临床医生PTP评估的频率和CD PCR结果阳性患者的疾病严重程度的特征.
分析PTP,诊断测试结果和CD感染 (CDI) 治疗之间的相关性.

主要方法:

对483名阳性CDPCR的成年患者进行了回顾性研究.
基于CD PCR,GDH,毒素A/B结果和临床医生评估的PTP (高,中等,低) 的队列分析.
多变量回归以确定毒素阳性的预测因素.

主要成果:

只有22%的CD PCR阳性患者也对GDH和CD毒素呈阳性.
较低的PTP与负的CD毒素结果相关 (11%阳性) 与高的PTP (63%阳性) 相比.
高达64%的GDH和毒素阴性患者接受了CD治疗;之前的抗生素,发烧和中度至高的PTP预测了毒素阳性.

结论:

在GIPCR上的CD PCR阳性结果通常不会通过毒素检测得到证实.
对于CDI的治疗通常是不管PTP或毒素的结果.
在GIPCR上解释CD阳性需要谨慎,特别是低PTP.

关键词:

克洛斯特里迪奥伊德困难感染.分子面板分子面板预测测试概率的可能性.

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