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Clin Infect Dis. 2013 Oct;57(8):1175-81. doi: 10.1093/cid/cit424. Epub 2013 Jun 20.

Laboratory diagnosis of Clostridium difficile infections: there is light at the end of the colon.

Author information

1
Pathology and Laboratory Medicine, VA Boston Healthcare System, West Roxbury.

Abstract

Single molecular or multistep assays (glutamate dehydrogenase, toxin A/B, ± molecular) are recommended for the diagnosis of CDI in patients with clinically significant diarrhea. Rapid and accurate tests can improve resource allocations and improve patient care. Enzyme immunoassay (EIA) for toxins A/B is too insensitive for use as a stand-alone assay. This guideline will examine the use of molecular tests and multitest algorithms for the diagnosis of Clostridium difficile infection (CDI). These new tests, alone or in a multistep algorithm consisting of >1 assay, are more expensive than the older EIA assays; however, rapid and accurate testing can save money overall by initiating appropriate treatment and infection control protocols sooner and by possibly reducing length of hospital stay. We recommend testing only unformed stool in patients with clinically significant diarrhea by a molecular method or by a 2- to 3-step algorithm.

KEYWORDS:

Brecher guidelines; Clostridium difficile; laboratory design of C. difficile

PMID:
23788237
DOI:
10.1093/cid/cit424
[Indexed for MEDLINE]

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