Laboratory Diagnosis of <i>Clostridium difficile</i> Infection in Korea: The First National Survey

Chung, Hae Sun; Park, Jeong Su; Shin, Bo Moon

doi:10.3343/alm.2019.39.3.317

Cited by 6 publications

(6 citation statements)

References 20 publications

(39 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The pooled sensitivities of GDH EIAs and NAATs were somewhat lower than those reported by the ESCMID group (96% and 95%, respectively) [ 3 ]. However, there was no difference between the pooled sensitivities of toxin AB EIAs in our study and that by the ESCMID group (57%) [ 5 ]. The pooled specificities were 94.6%, 97.0%, and 95.8% for GDH EIAs, toxin AB EIAs, and NAATs, respectively ( Table 2 ), which were similar to those reported by the ESCMID group (96%, 99%, 98%, respectively) [ 3 ].…”

Section: Discussionmentioning

confidence: 60%

“…Some EIAs are performed through an automated process that minimizes the manual process during the test. Among NAATs, Xpert C. difficile (Cepheid, Sunnyvale, CA, USA), BD Max Cdiff (Becton Dickinson, Sparks, MD, USA), and AdvanSure CD (LG Chem., Seoul, Korea) have been used with a relatively high frequency in Korea [ 5 ]. The information for each diagnostic method is shown in Table 1 .…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Laboratory Diagnostic Methods for Clostridioides difficile Infection: the First Systematic Review and Meta-analysis in Korea

2021

Self Cite

View full text Add to dashboard Cite

Background Various methods are used for the diagnosis of Clostridioides difficile infection (CDI). We systematically analyzed and investigated the performance of current laboratory diagnostic methods for CDI. Methods We performed systematic review and meta-analysis of studies in PubMed, Web of Science, Cochrane Library, and KoreaMed. The following methods were evaluated glutamate dehydrogenase (GDH) enzyme immunoassays (GDH EIAs), toxin A and B detection by enzyme immunoassays (toxin AB EIAs), and nucleic acid amplification tests (NAATs) for C. difficile toxin genes. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of each method were calculated. Results Based on 39 studies, the pooled sensitivities/specificities were 92.7%/94.6%, 57.9%/97.0%, and 90.0%/95.8% for GDH EIAs, toxin AB EIAs, and NAATs, respectively, compared with those of toxigenic culture. The pooled sensitivities of automated EIAs were significantly higher than those of non-automated EIAs for both GDH and toxins A and B. The pooled sensitivity of Xpert C. difficile was significantly higher than those of other NAATs. PPVs increased as CDI prevalence increased, and NPVs were excellent when CDI prevalence was low; at CDI prevalence of 5%, PPV = 37%-65% and NPV = 97%-100%; at CDI prevalence of 50%, PPV = 92%-97% and NPV = 65%-98%. Conclusions Toxin AB EIAs still show unsatisfactory sensitivity, whereas GDH EIAs and NAATs show relatively high sensitivity. However, toxin AB EIAs are the most specific tests. This study may provide useful information for CDI diagnosis.

show abstract

Section: Discussionmentioning

confidence: 60%

Section: Methodsmentioning

confidence: 99%

Laboratory Diagnostic Methods for Clostridioides difficile Infection: the First Systematic Review and Meta-analysis in Korea

2021

Self Cite

View full text Add to dashboard Cite

show abstract

“…In this regard, Putsathit et al ( 2017 ) from Thailand and Zhou et al ( 2019 ) from China, used the ChromID agar culture medium to detect C. difficile in their studies. However, one of the disadvantages of phenotypic methods such as culture is their inability to differentiate between toxin-producing and non-toxin-producing strains of C. difficile (Chung et al 2019 ). Therefore, the use of molecular methods such as PCR, real-time PCR, and LAMP assay is more sensitive and specific options in this regard and can detect the toxigenic C. difficile strain in different sources (Zhou et al 2019 ; Marcos et al 2021 ).…”

Section: Discussionmentioning

confidence: 99%

Loop mediated isothermal amplification of Clostridioides difficile isolates in gastrointestinal patients

et al. 2022

View full text Add to dashboard Cite

This study investigated the prevalence of Clostridioides difficile by culture, multiplex polymerase chain reaction (M-PCR), and loop mediated isothermal amplification (LAMP) in patients with suspected C. difficile infections (CDIs). Also, the results of three methods were compared. All stool specimens collected from CDI suspected patients were cultured on selective C. difficile cycloserine-cefoxitin fructose agar and incubated in an anaerobic jar up to 7 days. The bacterial isolates were identified using standard tests. Multiplex-PCR (M-PCR) was performed for detection of tcdA, tcdB, and tpi genes. The LAMP assay was performed to detect the tcdB gene of C. difficile. C. difficile was isolated from 20.0% (n = 10/50) of samples by culture. M-PCR showed that 34.0% (n = 17/50) of the specimens were positive for C. difficile based on the presence of tpi gene. Out of the 17 C. difficile, 13 strains (76.0%) were positive for tcdB gene using M-PCR. However, the LAMP assay showed that 30.0% (15/50) of specimens were positive for the presence of tcdB gene. M-PCR and LAMP methods showed 100.0% sensitivity compared to the culture method. However, the specificity of the LAMP (87.5%) was relatively higher than the M-PCR (82.5%) compared to the culture. Based on the results of this study, the prevalence of toxigenic C. difficile strains was high in suspected CDI patients. So, the differentiation between toxigenic and non-toxigenic strains is necessary. Our data showed that the LAMP assay is a good method for direct detection of toxigenic C. difficile strains from stool specimens.

show abstract

“…On the other hand, a combination of NAAT and C. difficile culture tests, either alone or in conjunction with other tests, was employed by 37 laboratories. 14 …”

Section: Introductionmentioning

confidence: 99%

Assessment of Knowledge and Practice of Healthcare Providers in Saudi Arabia Regarding Clostridioides difficile Infection Diagnosis and Management: A Cross-Sectional Questionnaire-Based Study

Almutairi,

Alnezary,

Alsuwaylim

et al. 2024

IDR

View full text Add to dashboard Cite

Introduction Diagnosis of Clostridioides difficile infection (CDI) depends on clinical presentation and laboratory testing. Stool diagnostic tests are essential for effective detection of toxigenic C. difficile strains. No study to date has evaluated the readability of microbiology labs in Saudi Arabia to test for CDI and evaluated the knowledge and practice of healthcare providers regarding CDI management. Therefore, this study aimed to assess the knowledge and practice of healthcare providers in Saudi Arabia regarding CDI diagnosis and treatment. Methods A cross-sectional, descriptive, questionnaire-based study was conducted on healthcare providers in Saudi Arabia, primarily physicians and clinical pharmacists. The questionnaire was developed based on a literature review and input from infectious diseases experts. The questionnaire was administered online. Data were analyzed using descriptive and inferential statistics. Results Of 183 respondents, 27.9% had adequate knowledge on CDI diagnosis and management. The majority were internal medicine specialists (37.7%) working in governmental or semi-governmental hospitals (80.9%) in central (46.6%) or southern (30.1%) regions of Saudi Arabia. Most participants assessed laxative use (86.3%) and reported positive C. difficile specimens to infection control (67.2%). However, knowledge varied, with 57.4% supporting unnecessary retesting and 53% assuming positive PCR test indicates moderate CDI probability. Factors such as specialization, hospital accreditation status, and bed capacity influenced knowledge levels (p<0.01 for all factors). Conclusion The study revealed a significant knowledge gap among Saudi healthcare providers regarding CDI diagnosis, management, and severity classification, highlighting the need for improved education and adherence to guidelines to improve patient outcomes and reduce recurrence risks.

show abstract

Laboratory Diagnosis of Clostridium difficile Infection in Korea: The First National Survey

Cited by 6 publications

References 20 publications

Laboratory Diagnostic Methods for Clostridioides difficile Infection: the First Systematic Review and Meta-analysis in Korea

Laboratory Diagnostic Methods for Clostridioides difficile Infection: the First Systematic Review and Meta-analysis in Korea

Loop mediated isothermal amplification of Clostridioides difficile isolates in gastrointestinal patients

Assessment of Knowledge and Practice of Healthcare Providers in Saudi Arabia Regarding Clostridioides difficile Infection Diagnosis and Management: A Cross-Sectional Questionnaire-Based Study

Contact Info

Product

Resources

About