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Three different patterns of positive Clostridium difficile laboratory tests. A comparison of clinical behavior.

Abstract：

:Clostridium difficile (CD) diagnosis is very varied and under discussion. Different research groups disagree on the clinical significance of patients with negative direct toxin and positive polymerase chain reaction (PCR) or even more with direct toxin and glutamate dehydrogenase (GDH) both negatives, but CD detected by toxigenic culture (TC). The objective was to analyze the characteristics of patients with 3 different diagnostic criteria. We compared these 3 groups of patients: group 1: (GDH+/direct toxin+/PCR+), group 2: (GDH+/direct toxin-/PCR+) and group 3: (GDH-/direct toxin-/PCR not done/TC+). The proportion of patients with CD infection (CDI) (not colonization) for groups 1 to 3 was, respectively, 90.3%, 95.4%, and 59.1%. No differences between severity (40.8%, 38.5%, 27.3%), recurrence (20.3%, 24.1%, 7.6%), or related mortality (12.5%, 5.2%, 0%) were found within the 3 groups of patients. Laboratory clinical results should not be used as the only tool to differentiate CDI versus colonization or severity. We recommend that PCR or a second-look TC be performed on all patients.

journal_name

Diagn Microbiol Infect Dis

journal_title

Diagnostic microbiology and infectious disease

authors

Olmedo M,Alcalá L,Valerio M,Marín M,Onori R,Reigadas E,Muñoz P,Bouza E

doi

10.1016/j.diagmicrobio.2020.115050

subject

Has Abstract

pub_date

2020-07-01 00:00:00

pages

115050

issue

3

eissn

0732-8893

issn

1879-0070

pii

S0732-8893(19)31006-5

journal_volume

97

pub_type

杂志文章

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