title: Clinical and laboratory characteristics of Clostridium difficile infection in patients with discordant diagnostic test results.
abstract: The aim of this study was to compare the clinical and laboratory characteristics of Clostridium difficile infection (CDI) in patients with discordant test results for the cytotoxin assay (CYT) and PCR assays. A retrospective study from May to August 2008 and March to May 2010 was performed. CDI was diagnosed in 128 patients. PCR increased the yield of C. difficile cases by 2-fold compared to that of the CYT assay. Fifty-six cases (44%) were detected by PCR only (CYT negative). Forty-nine percent of patients with non-NAP1 strains were detected by PCR only, compared to 28% of those infected with NAP1 strains (P < 0.05). No significant differences were found in the clinical severity of illness and outcome among patients that tested positive for CDI by both tests (CYT and PCR) compared to those that tested positive by PCR only.
authors.affiliation: Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
authors.forename: Anna
authors.initials: A
authors.lastname: Kaltsas
authors.forename: Matt
authors.initials: M
authors.lastname: Simon
authors.forename: Larissa H
authors.initials: LH
authors.lastname: Unruh
authors.forename: Crystal
authors.initials: C
authors.lastname: Son
authors.forename: Danielle
authors.initials: D
authors.lastname: Wroblewski
authors.forename: Kimberlee A
authors.initials: KA
authors.lastname: Musser
authors.forename: Kent
authors.initials: K
authors.lastname: Sepkowitz
authors.forename: N Esther
authors.initials: NE
authors.lastname: Babady
authors.forename: Mini
authors.initials: M
authors.lastname: Kamboj
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001426:Bacterial Proteins / Q000235:genetics; D001427:Bacterial Toxins / Q000737:chemistry / Q000235:genetics; D002648:Child; D002675:Child, Preschool; D016360:Clostridioides difficile / Q000235:genetics*; D003015:Clostridium Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology; D003428:Cross Infection / Q000175:diagnosis* / Q000453:epidemiology / Q000382:microbiology; D005188:False Negative Reactions; D005243:Feces / Q000737:chemistry / Q000382:microbiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D025202:Molecular Diagnostic Techniques; D016133:Polymerase Chain Reaction; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D001426:Bacterial Proteins; D001427:Bacterial Toxins; C031815:toxB protein, Clostridium difficile