<i>Clostridium difficile</i>
            Testing: after 20 Years, Still Challenging

Wilkins, Tracy D.; Lyerly, David M.

doi:10.1128/jcm.41.2.531-534.2003

Cited by 138 publications

(101 citation statements)

References 21 publications

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“…The tissue culture cytotoxicity assay detecting the presence of C. difficile cytotoxin (toxin B) in stool filtrate is considered to be the "gold standard" for diagnosis because of its high specificity (99%-100%). 59,60 The sensitivity of this test is 80%-90%. 61,62 Performance of the test requires a tissue culture facility, and results are usually not available for at least 48 hours.…”

Section: Diagnosismentioning

confidence: 99%

Clostridium difficile-associated diarrhea in adults

Poutanen

Simor²

2004

Canadian Medical Association Journal

358

280

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CLOSTRIDIUM DIFFICILE is the most important cause of nosocomial diarrhea in adults. Illness may range from mild watery diarrhea to life-threatening colitis. An antecedent disruption of the normal colonic flora followed by exposure to a toxigenic strain of C. difficile are necessary first steps in the pathogenesis of disease. Diagnosis is based primarily on the detection of C. difficile toxin A or toxin B. First-line treatment is with oral metronidazole therapy. Treatment with oral vancomycin therapy should be reserved for patients who have contraindications or intolerance to metronidazole or who fail to respond to first-line therapy

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Section: Diagnosismentioning

confidence: 99%

Clostridium difficile-associated diarrhea in adults

Poutanen

Simor²

2004

Canadian Medical Association Journal

358

280

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“…Although the antitoxin assay is very sensitive, improper handling of the stool specimen may result in inactivation of the toxin. 19 Exclusion of all patients with diarrhea who were negative for C. difficile toxin should have decreased the risk of misclassifying the control subjects, but it may have resulted in an underestimate of the incidence.…”

Section: Limitationsmentioning

confidence: 99%

“…19 The studies were approved by the Ethics Review Board of the McGill University Health Centre for the cohort study and by the Jewish General Hospital Ethics Board for the case-control study.…”

Section: Data Collectionmentioning

confidence: 99%

Risk of Clostridium difficile diarrhea among hospital inpatients prescribed proton pump inhibitors: cohort and case-control studies

Dial¹,

Al-Rasadi²,

Manoukian

et al. 2004

Canadian Medical Association Journal

519

304

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“…The GDH is a common antigen expressed at high levels by all C. difficile strains. However, the test only documents the presence of C. difficile, but not the presence of a toxigenic strain (20% of C. difficile strains do not produce toxin) or the presence of toxin in stool [58] . Therefore, GDH (+) stool requires confirmation of toxin production with a second test.…”

Section: Laboratory Diagnosis Of CDImentioning

confidence: 99%

Clinical update for the diagnosis and treatment ofClostridium difficileinfection

Oldfield

Johnson

2014

WJGPT

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Clostridium difficile infection (CDI) presents a rapidly evolving challenge in the battle against hospitalacquired infections. Recent advances in CDI diagnosis and management include rapid changes in diagnostic approach with the introduction of newer tests, such as detection of glutamate dehydrogenase in stool and polymerase chain reaction to detect the gene for toxin production, which will soon revolutionize the diagnostic approach to CDI. New medications and multiple medical society guidelines have introduced changing concepts in the definitions of severity of CDI and the choice of therapeutic agents, while rapid expansion of data on the efficacy of fecal microbiota transplantation heralds a revolutionary change in the management of patients suffering multiple relapses of CDI. Through a comprehensive review of current medical literature, this article aims to offer an intensive review of the current state of CDI diagnosis, discuss the strengths and limitations of available laboratory tests, compare both current and future treatments options and offer recommendations for best practice strategies.

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Clostridium difficile Testing: after 20 Years, Still Challenging

Cited by 138 publications

References 21 publications

Clostridium difficile-associated diarrhea in adults

Clostridium difficile-associated diarrhea in adults

Risk of Clostridium difficile diarrhea among hospital inpatients prescribed proton pump inhibitors: cohort and case-control studies

Clinical update for the diagnosis and treatment ofClostridium difficileinfection

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