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多步算法在Clostridioides difficile诊断中的高流行程度实验室测试

Kaede V Sullivan^1,2, Rhona J Souers³, Erica Hillesland³

¹From the Department of Pathology and Laboratory Medicine, Temple University Health System, Philadelphia, Pennsylvania (Sullivan).

Archives of pathology & laboratory medicine

|August 5, 2024

概括

对于Clostridioides difficile感染 (CDI) 的实验室测试主要使用多步算法. 虽然形成的便经常被拒绝,但对婴儿和药使用者的测试为改善CDI诊断实践提供了机会.

科学领域:

临床微生物学临床微生物学
传染性疾病传染性疾病
实验室诊断实验室诊断实验室诊断

背景情况:

由于更新的指导方针,敏感的核酸放大试验 (NAAT),对NAAT特异性的担忧以及报告要求,Clostridioides difficile感染 (CDI) 诊断的实验室测试实践已经发展.
CDI诊断的景观是动态的,受到技术进步和不断变化的临床建议的影响.

研究的目的:

评估用于诊断Clostridioides difficile感染 (CDI) 检测的实验室实践的现状.
了解在临床实验室采用各种测试算法和样本拒绝标准的情况.

主要方法:

2019年12月,向1374个参与美国病理学家学院C difficile检测 (CDF) 能力测试计划挑战CDF-C的实验室分发了一个可选的8项补充问卷.
获得了84.4%的响应率 (1160个实验室),大多数参与者位于美国.

主要成果:

大多数响应的实验室 (59.0%) 使用多步测试算法进行CDI诊断.
最常见的方法是使用谷氨酸脱酶和毒素A / B组合试验进行初始测试,然后对不一致的结果进行NAAT (31.4%).
大多数实验室 (96.6%) 拒绝形成的便进行CDI测试,但拒绝对儿科患者 (18.7%) 和使用药的患者 (36.0%在美国实验室) 进行测试的情况不太一致.

结论:

广泛采用CDI诊断的多步算法,与当前的建议保持一致.
在CDI测试中观察到形成的便被广泛拒绝.
实验室有机会通过改善对婴儿和使用药的患者进行测试的拒绝标准来完善CDI测试实践.

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