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Clostridium difficile Infections in Children: Impact of the Diagnostic Method on Infection Rates
- Source :
- Infection Control & Hospital Epidemiology. 37:1087-1093
- Publication Year :
- 2016
- Publisher :
- Cambridge University Press (CUP), 2016.
-
Abstract
- BACKGROUNDPolymerase chain reaction (PCR) assays based on the detection of the toxin B gene are replacing enzyme-linked immunosorbent assay (ELISA)–based toxin production detection or cell cytotoxicity assay in most laboratories.OBJECTIVETo determine the proportion of pediatric patients diagnosed withClostridium difficile infection by PCR who would have also been diagnosed by ELISA and to compare the clinical characteristics of PCR+/ELISA+ vs PCR+/ELISA− patients.METHODSUsing the microbiology laboratory information system, stool samples positive for C. difficile by PCR between October 2010 and July 2014 were identified. Using frozen stool specimens, an ELISA for toxin A and B was performed. A retrospective medical chart review was conducted to obtain demographic and clinical data. Duplicate samples were excluded.RESULTSA total of 136 PCR-positive samples underwent ELISA testing: 54 (40%) were positive for toxin A or B. The mean (SD) age of the entire cohort was 8.5 (6.2) years. There was no difference in age, gender, clinical manifestation, previous medical problems, and management between patients positive or negative by ELISA. However, patients positive by ELISA were more likely to have had a recent exposure to antibiotics (67.9% vs 50%; crude odds ratio, 2.1 [95% CI, 1.03–4.28]).CONCLUSIONIn our pediatric population, 60% of patients with C. difficile diagnosed by PCR had no toxin detectable by ELISA. ELISA-negative patients were less likely to have received an antibiotic recently compared with ELISA-positive patients. These results highlight the need to standardize laboratory criteria for the diagnosis of C. difficile infections in children.Infect Control Hosp Epidemiol 2016;37:1087–1093
- Subjects :
- Male
0301 basic medicine
Microbiology (medical)
medicine.medical_specialty
Adolescent
Epidemiology
medicine.drug_class
Bacterial Toxins
030106 microbiology
Antibiotics
Clostridium difficile toxin A
Enzyme-Linked Immunosorbent Assay
Clostridium difficile toxin B
Polymerase Chain Reaction
Sensitivity and Specificity
Gastroenterology
law.invention
Feces
03 medical and health sciences
0302 clinical medicine
law
Internal medicine
Humans
Medicine
030212 general & internal medicine
Child
Polymerase chain reaction
Retrospective Studies
Clostridioides difficile
business.industry
Quebec
Infant
Retrospective cohort study
Odds ratio
Clostridium difficile
Infectious Diseases
Child, Preschool
Clostridium Infections
Female
business
Subjects
Details
- ISSN :
- 15596834 and 0899823X
- Volume :
- 37
- Database :
- OpenAIRE
- Journal :
- Infection Control & Hospital Epidemiology
- Accession number :
- edsair.doi.dedup.....63a15ab376238f041d4b0b2cf9be0b6b