Response to Prior and Fitzpatrick

Kundrapu, Sirisha; Sunkesula,; Tomas, Myreen; Cj, Donskey

doi:10.1017/ice.2015.338

Cited by 4 publications

(1 citation statement)

References 11 publications

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“…Our laboratory began to restrict testing to patients with three or more unformed stools within 24 hours in November 2016. It is likely that many asymptomatic carriers of toxigenic C. difficile with unformed stool due to other causes were diagnosed with CDI, resulting in unnecessary treatment and inflation of CDI rates [ 23 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

Identification of Clostridium difficile Asymptomatic Carriers in a Tertiary Care Hospital

Silva

Marra

Martino

et al. 2017

BioMed Research International

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Background The diagnosis of Clostridium difficile infection (CDI) increases concern that asymptomatic carriers of toxigenic C. difficile may be diagnosed with CDI. Methods A matched case control study was conducted in inpatients in a tertiary care center. The first 50 patients with diarrhea and a positive polymerase chain reaction (PCR) test beginning February 1, 2015, were identified as cases. Control patients were hospitalized patients receiving antibiotics, but with no diarrhea, housed in a room as close as possible to each case during the same admission time. A convenience sample of healthcare workers who cared for C. difficile infected patients was also tested. Results We found two positive PCR results for C. difficile in controls (4.1%). None of these healthcare workers were positive for C. difficile by PCR. There was no difference between groups with respect to overall antibiotic use before the requested PCR for Clostridium difficile (p = 0.359). The majority of cases had a high proportion of gastrointestinal disorders (71.4%) compared with control (8.2%), p < 0.001. Patients with neoplasia had a higher chance of being identified as cases (p = 0.041). Conclusions PCR should not be the only diagnostic tool but should be complementary to other methods and to the medical history.

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Section: Discussionmentioning

confidence: 99%