Clostridium difficile Infection

Wilcox, Mark H.

doi:10.1016/s0891-5520(15)00009-4

Cited by 2 publications

(2 citation statements)

References 127 publications

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“…A more recent discussion of diagnostic pitfalls is provided by Wilcox et al . Important considerations include: Diagnostic testing should not be performed on patients who are asymptomatic, or are minimally symptomatic or who have laxative‐associated diarrhoea. Diagnostic strategies that test on physician request underestimate the prevalence of C. difficile and it is recommended that regardless of request, laboratories automatically test unformed stools from patients hospitalised for >72 h for toxigenic C. difficile Laboratories should reject formed or soft stools for C. difficile testing; test only watery or loose stools that adopt the shape of the container.…”

Section: What Are the Principles Of CDI Diagnosis?mentioning

confidence: 99%

Australasian Society of Infectious Diseases updated guidelines for the management of Clostridium difficile infection in adults and children in Australia and New Zealand

Trubiano

Cheng

Korman

et al. 2016

Internal Medicine Journal

128

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The incidence of Clostridium difficile infection (CDI) continues to rise, whilst treatment remains problematic due to recurrent, refractory and potentially severe nature of disease. The treatment of C. difficile is a challenge for community and hospital-based clinicians. With the advent of an expanding therapeutic arsenal against C. difficile since the last published Australasian guidelines, an update on CDI treatment recommendations for Australasian clinicians was required. On behalf of the Australasian Society of Infectious Diseases, we present the updated guidelines for the management of CDI in adults and children.

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Section: What Are the Principles Of CDI Diagnosis?mentioning

confidence: 99%

Australasian Society of Infectious Diseases updated guidelines for the management of Clostridium difficile infection in adults and children in Australia and New Zealand

Trubiano

Cheng

Korman

et al. 2016

Internal Medicine Journal

128

View full text Add to dashboard Cite

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“…lostridium difficile infection (CDI) is the leading bacterial cause of nosocomial diarrhea in hospitalized patients (1)(2)(3)(4). The incidence of CDI has increased in the last decade and community onset disease has been encountered in patients without previous health care exposure or antibiotic use (5)(6)(7).…”

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confidence: 99%

Real-Time Cellular Analysis Coupled with a Specimen Enrichment Accurately Detects and Quantifies Clostridium difficile Toxins in Stool

Huang

Jin

Zhang³

et al. 2014

J Clin Microbiol

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We describe here the use of an immunomagnetic separation enrichment process coupled with a modified real-time cellular analysis (RTCA) system (RTCA version 2) for the detection of C. difficile toxin (CDT) in stool. The limit of CDT detection by RTCA version 2 was 0.12 ng/ml. Among the consecutively collected 401 diarrheal stool specimens, 53 (13.2%) were toxin-producing C. difficile strains by quantitative toxigenic culture (qTC); bacterial loads ranged from 3.00 ؋ 10 1 to 3.69 ؋ 10 6 CFU/ml. The RTCA version 2 method detected CDT in 51 samples, resulting in a sensitivity of 96.2%, a specificity of 99. C lostridium difficile infection (CDI) is the leading bacterial cause of nosocomial diarrhea in hospitalized patients (1-4). The incidence of CDI has increased in the last decade and community onset disease has been encountered in patients without previous health care exposure or antibiotic use (5-7).A definitive laboratory diagnosis of CDI depends on a stool test result positive for the presence of toxigenic C. difficile or its toxins (CDT) or colonoscopic or histopathologic findings demonstrating pseudomembranous colitis (8). Currently, laboratory methods used for the diagnosis of CDI are based on detection of C. difficile-specific antigen (e.g., glutamate dehydrogenase enzyme immunoassay [EIA]), toxin proteins (toxin A/B EIA, toxigenic culture [TC], cell cytotoxicity neutralization assay [CCNA]), or toxin genes (real-time PCR [RT-PCR] and loop-mediated isothermal amplification assay) (9-14). Molecular diagnostic techniques, including RT-PCR and other molecular assays, have the advantages of higher sensitivities and rapid turnaround times and are increasingly being implemented for routine diagnostic use (15-17).While molecular-based tests have high sensitivity and are faster, these assays detect the presence of toxin-encoding genes, and they may not be able to distinguish between infection and colonization as well as live and dead C. difficile organisms in certain circumstances (18,19). Recent studies highlighted the importance of detecting and quantifying CDT (20,21). Planche et al. recently noted no increase in mortality when toxigenic C. difficile alone was present, while toxin determined by cytotoxin assay positivity correlated with clinical outcome. CDT correlated with the clinical severity of CDI (21). Leslie et al. found that toxin-negative patients had a lower level of C. difficile than toxin-positive patients (22). These results suggested that toxin quantification could be used clinically to predict toxin status and help distinguish patients with CDI from carriers with diarrhea due to other causes (21).We previously reported on the use of a real-time cellular analysis (RTCA) assay (ACEA Biosciences, San Diego, CA) for quantitative detection of CDT directly from stool (23). This assay is based on microelectronic sensor-based cellular analysis technology (23). Cell index (CI) is a dimensionless parameter to represent cell status based on the change of the electrode impedance. The impedance readout harness...

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Clostridium difficile Infection

Cited by 2 publications

References 127 publications

Australasian Society of Infectious Diseases updated guidelines for the management of Clostridium difficile infection in adults and children in Australia and New Zealand

Australasian Society of Infectious Diseases updated guidelines for the management of Clostridium difficile infection in adults and children in Australia and New Zealand

Real-Time Cellular Analysis Coupled with a Specimen Enrichment Accurately Detects and Quantifies Clostridium difficile Toxins in Stool

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