Characteristics of Clostridium difficile infection in patients with discordant diagnostic test results
Rev. esp. enferm. dig
; 108(6): 304-308, jun. 2016. tab, ilus
Artigo
em Inglês
| IBECS
| ID: ibc-153421
Biblioteca responsável:
ES1.1
Localização: BNCS
ABSTRACT
Background:
Clinical features of Clostridium difficile infection (CDI) cases diagnosed by detection of polymerase chain reaction (PCR), with negative toxin enzyme immunoassay results (EIA) have not been fully elucidated. The purpose of this study was to determine the magnitude of CDI patients who had negative EIA toxin determinations but positive PCR tests, and their differences in clinical presentation.Methods:
We performed a retrospective study comparing the clinical features of CDI cases detected by EIA (toxins A + B) with cases detected by PCR (toxin negative, PCR positive) over a 16-month period. Only patients with an initial Clostridium difficile infection episode that fulfilled a standardized definition were included.Results:
During the study period, 107 episodes of CDI were detected. Seventy-four patients (69%) had positive glutamate dehydrogenase (GDH) antigen and EIA determinations (EIA positive patients). Thirty-three patients (31%) had GDH positive, negative toxin EIA and positive PCR determination (PCR positive patients). PCR positive patients were younger, 57 (27) years (mean [SD]), than EIA positive patients, 71 (16) years, (p < 0.001). Fewer PCR positive patients were receiving proton pump inhibitors (21 patients, 64%) than EIA positive patients (61 patients, 82%, p = 0.034). The clinical presentation was similar in both groups. In the multivariate analysis, lower age was identified as the only independent variable associated with PCR positive patients.Conclusions:
One third of Clostridium difficile infection patients present negative toxin EIA and PCR positive tests. Performing PCR determination after the negative EIA test is more relevant in younger patients (AU)RESUMEN
No disponible
Texto completo:
Disponível
Coleções:
Bases de dados nacionais
/
Espanha
Contexto em Saúde:
Doenças Negligenciadas
Problema de saúde:
Diarreia
/
Doenças Negligenciadas
Base de dados:
IBECS
Assunto principal:
Reação em Cadeia da Polimerase
/
Clostridioides difficile
/
Bombas de Próton
/
Diarreia
/
Antibacterianos
Tipo de estudo:
Estudo diagnóstico
/
Estudo observacional
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Estudo prognóstico
/
Fatores de risco
Limite:
Adulto
/
Feminino
/
Humanos
/
Masculino
Idioma:
Inglês
Revista:
Rev. esp. enferm. dig
Ano de publicação:
2016
Tipo de documento:
Artigo
Instituição/País de afiliação:
Hospital Universitario Puerta de Hierro Majadahonda/Spain
/
Spanish Network for Research in Infectious Diseases (REIPI)/Spain