Recommendations for the diagnosis and treatment of Clostridioides difficile infection: An official clinical practice guideline of the Spanish Society of Chemotherapy (SEQ), Spaish Society of Internal Medicine (SEMI) and the working group of Postoperative Infection of the Spanish Society of Anesthesia and Reanimation (SEDAR)

Abstract

ned leukocytosis, even in the absence of classical risk factors. With a few exceptions, a single stool sample is sufficient for diagnosis, which can be sent to the laboratory with or without transportation media for enteropathogenic bacteria. In the absence of diarrhoea, rectal swabs may be valid. The microbiology laboratory should include C. difficile among the pathogens routinely searched in patients with diarrhoea. Laboratory tests in different order and sequence schemes include GDH detection, presence of toxins, molecular tests and toxigenic culture. Immediate determination of sensitivity to drugs such as vancomycin, metronidazole or fidaxomycin is not required. The evolution of toxin persistence is not a suitable test for follow up. Laboratory diagnosis of CDI should be rapid and results reported and interpreted to clinicians immediately. In addition to the basic support of all diarrheic episodes, CDI treatment requires the suppression of antiperistaltic

Clinical and microbial characterization of toxigenic Clostridium difficile isolated from antibiotic associated diarrhea in Egypt

“…Early detection of CDI and its toxins is critical to allow earlier treatment that can significantly reduce the morbidity, mortality, medical cost and family burden of CDI. The Food and Drug Administration (FDA) has approved a number of laboratory tests for the diagnosis of CDI including toxinogenic culture (TC), cell cytotoxicity neutralization assay (CCNA), enzyme immunoassays (EIA) for toxins A, B, and/ or glutamate dehydrogenase (GDH), and nucleic acid amplification tests (NAATs) (6).…”

Clostridioides difficile infection in a long-term convalescence hospital: A real tale of pitfalls and outdated therapy

“…Considering therapeutic approach, 78.4% of individuals with an initial episode were treated with metronidazole, which was the drug of choice until 2017. However, last guidelines [ 5 , 6 ] advise about the use of vancomycin or fidaxomicin as first line in all patients with first episode of CDI [ 13 - 15 ]. So, it could be said that the degree of penetrance of current therapeutic guidelines is poor in our hospital.…”

“…We have performed a retrospective study of all CDI cases since 5th May 2016 to 31st December 2019. We used the definitions of nosocomial, community-acquired and recurrent CDI reported in updated guidelines [ 5 , 6 ]. In every patient with a clinical picture suggestive of CDI (diarrhoea, abdominal pain, fever), a faecal sample was collected and analysed at the microbiology laboratory of the hospital, using C. difficile quik check complete (Techlab® Blacksburg) test.…”

Economic burden of recurrent Clostridioides difficile infection in adults admitted to Spanish hospitals. A multicentre retrospective observational study

“…The incidence may be up to 2.5 times higher in patients aged ≥ 65 years [ 9 ]. The increased frequency of CDI correlates with increased antibiotic use, prolonged hospital stays and older age [ 13 , 14 ].…”

“…Economic burden of recurrent Clostridioides difficile infection in adults admitted to Spanish hospitals. A multicentre retrospective observational study biotic use after the diagnosis of CDI, the use of antacid agents, older age [17,[20][21][22][23], the persistence of spores, loss of diversity of the gut microbiota [4,[24][25][26] and previous episodes of CDI [27], severe CDI episodes, an insufficient immune response and the persistence of diarrhoea >5 days [14], are the main risk factors for rCDI. The first recurrence increases the percentage of new recurrences by up to 50-60% [28][29][30].…”