Performance of laboratory tests for detection for Clostridioides difficile: A multicenter prospective study in Japan

Senoh, Mitsutoshi; Kato, Haru; Honda, Hitoshi; Fukuda, Tadashi; Tagashira, Yasuaki; Horiuchi, Hiroko; Chiba, Hiroshi; Suzuki, Daisuke; Hosokawa, Naoto; Kitazono, Hidetaka; Norisue, Yasuhiro; Kume, Hisashi; Môri, N.; Morikawa, H.; Kashiwagura, Saeko; Higuchi, Akiko; Kato, Hideaki; Nakamura, Makoto; Saori, Ishiguro; Morita, Sayuri; Ishikawa, Hideaki; Watanabe, Takuya; Kojima, Katsuyuki; Izumi, Yokomaku; Bando, Tatsuya; Kayoko, Toimoto; Moriya, Kyoji; Kasahara, Kei; Kitada, Shuichi; Ogawa, Jun; Saito, Haruko; Tominaga, Harumi; Shimizu, Yousuke; Masumoto, Fumi; Tadera, Kayoko; Yoshida, Junichi; Kikuchi, Tetsuya; Yoshikawa, Ichiro; Watanabe, Tatsuyuki; Honda, Masahisa; Kuniko, Yokote; Toyokawa, Takao; Miyazato, Hiroko; Nakama, Mika; Mahé, Cédric; Reske, Kimberly A.; Olsen, Margaret A.; Dubberke, Erik R.

doi:10.1016/j.anaerobe.2019.102107

Cited by 8 publications

(3 citation statements)

References 16 publications

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“…In addition, the C. difficile antigen test has better sensitivity, whereas the C. difficile toxin test has better specificity. However, Senoh et al [ 9 ] reported that the sensitivity and specificity of the C. difficile antigen test were 73% and 87%, respectively, which are lower in Japan than in Western countries. In addition, Deshpande et al [ 19 ] reported that among patients diagnosed with CDI who were positive for the C. difficile toxin, results were positive in the second (2.7%) and third tests (2.3%) despite a negative first test.…”

Section: Discussionmentioning

confidence: 99%

“…Although the number of CDI cases is gradually increasing worldwide [ 5 ], the background characteristics and clinical management of pediatric patients with CDI have not been fully clarified. In addition, despite some researchers reporting the accuracy (sensitivity and specificity) of C. difficile antigen/toxin tests, their reliability in diagnosing CDI in pediatric patients remains unknown [ 6 7 8 9 ]. Therefore, this study investigated the background and clinical course of pediatric patients with CDI in a tertiary children’s hospital in Japan and analyzed the reliability of each diagnostic test.…”

Section: Introductionmentioning

confidence: 99%

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Clostridioides difficile Infection in a Japanese Tertiary Children’s Hospital

Meguro

Nambu

Hara

et al. 2022

Pediatr Gastroenterol Hepatol Nutr

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Purpose Toxins produced by Clostridioides difficile infection (CDI) can cause enteritis and diarrhea. Although the number of pediatric CDI cases is increasing, the clinical management of pediatric CDI, including patient characteristics and prognosis, remains unclear. This study aimed to elucidate the background and clinical course of patients with CDI and evaluate the reliability of diagnostic tests in a tertiary pediatric hospital in Japan. Methods We retrospectively analyzed the clinical data of children diagnosed with CDI between 2011 and 2021 at the Saitama Children’s Medical Center in Saitama, Japan. Results During the study period, 1,252 C. difficile antigen/toxin tests were performed, and 37 patients were diagnosed with CDI. The main underlying diseases among the patients were hematological and malignant disorders and gastrointestinal diseases, including inflammatory bowel disease (IBD) (59.4%). Two patients (5.4%) had an unremarkable medical history. Among the 37 patients, 27 (73.0%) were immunocompromised, 25 (67.6%) had a history of antibiotic use within the past two months, and 6 (16.2%) were negative on the initial test but were positive on the second test. Finally, 28 patients (75.7%) required primary antibiotic therapy only, and two patients with IBD required additional antibiotic therapy as secondary treatment. Conclusion The number of pediatric patients with CDI is increasing. Both a comprehensive interview, including underlying diseases and history of antibiotic use, and an understanding of the features of clinical examinations should be emphasized to appropriately diagnose and treat CDI.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clostridioides difficile Infection in a Japanese Tertiary Children’s Hospital

Meguro

Nambu

Hara

et al. 2022

Pediatr Gastroenterol Hepatol Nutr

View full text Add to dashboard Cite

show abstract

“…Since clostridial toxins degrade rapidly, the toxin EIA testing has relatively poor sensitivity [ 41 , 42 ]. This necessitates the use of a second, more sensitive, test alongside toxin EIA testing [ 9 , 41 , 43 ]. Glutamate dehydrogenase (GDH) is an antigen found in high levels in C. difficile and is not present in appreciable levels in other related organisms [ 44 ].…”

Section: Laboratory Tests To Diagnose CDImentioning

confidence: 99%

Clostridioides difficile Infection: Diagnosis and Treatment Challenges

Markantonis,

Fallon,

Madan

et al. 2024

Pathogens

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Clostridioides difficile is the most important cause of healthcare-associated diarrhea in the United States. The high incidence and recurrence rates of C. difficile infection (CDI), associated with high morbidity and mortality, pose a public health challenge. Although antibiotics targeting C. difficile bacteria are the first treatment choice, antibiotics also disrupt the indigenous gut flora and, therefore, create an environment that is favorable for recurrent CDI. The challenge of treating CDI is further exacerbated by the rise of antibiotic-resistant strains of C. difficile, placing it among the top five most urgent antibiotic resistance threats in the USA. The evolution of antibiotic resistance in C. difficile involves the acquisition of new resistance mechanisms, which can be shared among various bacterial species and different C. difficile strains within clinical and community settings. This review provides a summary of commonly used diagnostic tests and antibiotic treatment strategies for CDI. In addition, it discusses antibiotic treatment and its resistance mechanisms. This review aims to enhance our current understanding and pinpoint knowledge gaps in antimicrobial resistance mechanisms in C. difficile, with an emphasis on CDI therapies.

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Clostridioides (Clostridium) difficile – Interesting and difficult

Rupnik

Janežič

2019

Anaerobe

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Performance of laboratory tests for detection for Clostridioides difficile: A multicenter prospective study in Japan

Cited by 8 publications

References 16 publications

Clostridioides difficile Infection in a Japanese Tertiary Children’s Hospital

Clostridioides difficile Infection in a Japanese Tertiary Children’s Hospital

Clostridioides difficile Infection: Diagnosis and Treatment Challenges

Clostridioides (Clostridium) difficile – Interesting and difficult

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