title: Optimizing the Laboratory Diagnosis of Clostridium difficile Infection.
abstract: The best laboratory diagnostic approach to detect Clostridium difficile infection (CDI) is the subject of ongoing debate. In the United States, nucleic acid amplification tests (NAAT) have become the most widely used tests for making this diagnosis. Detection of toxin in stool may be a better predictor of CDI disease and severity. Laboratories that have switched from toxin-based to NAAT-based methods have significantly higher CDI detection rates. The important issue is whether all NAAT-positive patients have CDI or at least some of those patients are excretors of the organism and do not have clinical disease.
authors.affiliation: Clinical Microbiology-Immunology Laboratories, Microbiology-Immunology, UNC Health Care, UNC School of Medicine, CB 7600, Chapel Hill, NC 27516, USA; Pathology-Laboratory Medicine, UNC School of Medicine, CB 7600, Chapel Hill, NC 27516, USA. Electronic address: gilliganncphd@gmail.com.
authors.forename: Peter H
authors.initials: PH
authors.lastname: Gilligan
mesh_terms: D000890:Anti-Infective Agents / Q000009:adverse effects; D016360:Clostridioides difficile / Q000145:classification / Q000235:genetics / Q000302:isolation & purification / Q000472:pathogenicity*; D003015:Clostridium Infections / Q000139:chemically induced / Q000175:diagnosis* / Q000453:epidemiology; D003937:Diagnosis, Differential; D005189:False Positive Reactions; D017408:Guidelines as Topic; D006801:Humans; D021141:Nucleic Acid Amplification Techniques / Q000379:methods; D012680:Sensitivity and Specificity; D014481:United States / Q000453:epidemiology
chemical_list: D000890:Anti-Infective Agents
keywords: Algorithm; Clostridium difficile; Diarrhea; Disease outcomes; Glutamate dehydrogenase; Microbiome; Nucleic acid amplification test (NAAT); Toxin