Molecular testing for viral and bacterial enteric pathogens: gold standard for viruses, but don’t let culture go just yet?

Bloomfield, Maxim G.; Balm, Michelle; Blackmore, Timothy

doi:10.1097/pat.0000000000000233

Cited by 22 publications

(16 citation statements)

References 29 publications

(24 reference statements)

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“…51 Infectious causes should be excluded using stool nucleic acid amplification tests or culture. 52 Fecal inflammatory markers such as calprotectin and lactoferrin can help in differentiating IBD from irritable bowel syndrome, but they can also be elevated in other inflammatory conditions. Calprotectin correlates significantly with mucosal inflammation in PIBD and can be used as a surrogate marker for inflammation; normalization indicates mucosal healing.…”

Section: Epidemiologymentioning

confidence: 99%

Diagnosis and management of inflammatory bowel disease in children

Oliveira

Monteiro

2017

BMJ

116

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Inflammatory bowel diseases (IBD), including Crohn's disease and ulcerative colitis, are lifelong conditions that often begin in childhood. The implications of IBD are of particular importance in children because of the potential negative effects on growth, development, psychosocial function, and overall wellbeing. The key management strategy is to achieve sustained control of intestinal inflammation and monitor for potential complications of the disease and side effects of therapies. Overall, the evidence on the management of IBD in children is less extensive than in adults, but good quality multicenter studies and various guidelines and society consensus statements are available. This review summarizes the evidence on the pathophysiology, diagnosis, and approaches to management of children and adolescents with IBD.

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Section: Epidemiologymentioning

confidence: 99%

Diagnosis and management of inflammatory bowel disease in children

Oliveira

Monteiro

2017

BMJ

116

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“…12,13 All have advantages and disadvantages, but sensitivity and specificity are generally high for these modalities and vary based on the specific test, sample, and organism. 14 False-negatives and cross reactivity are possible confounders in any methodology. Therefore, correlation of results with clinical findings, and a combination of tests, usually provides higher accuracy for definitive diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…14 Serologic assessments for circulating antigens or antibodies can be useful for many infections. Molecular methodology includes assays based on polymerase chain reaction, in situ hybridization, immunosorbent techniques, direct and indirect immunofluorescence, next-generation sequencing, and spectroscopy.…”

Section: Discussionmentioning

confidence: 99%

“…Contemporary diagnostic microbiology is progressively adopting molecular methods (eg, DNA/RNA-based assays) as first-line tests for a variety of samples. 14 Serologic assessments for circulating antigens or antibodies can be useful for many infections. Molecular methodology includes assays based on polymerase chain reaction, in situ hybridization, immunosorbent techniques, direct and indirect immunofluorescence, next-generation sequencing, and spectroscopy.…”

Section: Discussionmentioning

confidence: 99%

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Opportunistic Oral Infections

Sedghizadeh

Mahabady

Allen

2017

Dental Clinics of North America

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An opportunistic infection (OI) is a disease of microbial cause or pathogenesis generally thought to occur in hosts with weakened immunity. Oral OIs are associated with many risk factors and pathogens. Causative organisms for oral OIs have unique modes of transmission. The clinical presentation of oral OIs is heterogeneous and diagnosis can be challenging. Therefore, laboratory identification of causative pathogens is useful for definitive diagnosis and targeted therapeutics, and can be achieved by biological, serologic, histologic, and/or molecular methods. Clinical risk assessment and history with review of systems, and accurate diagnosis, treatment, and follow-up, are essential.

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“…Recent changes in C. difficile testing methods may further confound issues involving colonization. In recent years, most institutions have transitioned from enzyme‐immunoassay‐based testing for C. difficile toxin to NAAT due to their improved sensitivity and specificity . NAATs identify the DNA of the toxigenic strain of C. difficile , but not the toxin itself .…”

Section: Testing and Colonizationmentioning

confidence: 99%

Clostridium difficile infection in the pediatric transplant patient

Nicholson

Osgood

Acra

et al. 2015

Pediatric Transplantation

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CDIs are on the rise in both hospital and community settings in adults and children. Children with cancer or a history of HSCT or SOT appear to be at higher risk for primary disease, recurrent disease, and severe outcomes when compared to children with other comorbidities. The reasons for this are not clear and no studies to date have analyzed risk factors for CDI in pediatric transplant patients. Colonization rates in children with cancer and a transplant history are also high. Determining which children are colonized with Clostridium difficile and symptomatic from another source vs. symptomatic from CDI is difficult and a clinical conundrum for the transplant physician. The use of fecal transplantation for severe or rCDI is likely safe and effective in the immunosuppressed pediatric cancer or transplant patient, but this will need to be more thoroughly studied in this patient population.

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Molecular testing for viral and bacterial enteric pathogens: gold standard for viruses, but don’t let culture go just yet?

Cited by 22 publications

References 29 publications

Diagnosis and management of inflammatory bowel disease in children

Diagnosis and management of inflammatory bowel disease in children

Opportunistic Oral Infections

Clostridium difficile infection in the pediatric transplant patient

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