Current knowledge on the laboratory diagnosis ofClostridium difficileinfection.
Clostridium difficile(C. difficile) is a spore-forming, toxin-producing, gram-positive anaerobic bacterium that is the principal etiologic agent of antibiotic-associated diarrhea. Infection withC. difficile(CDI) is characterized by diarrhea in clinical syndromes that vary from self-limited to mild or severe. Since its initial recognition as the causative agent of pseudomembranous colitis,C. difficilehas spread around the world. CDI is one of the most common healthcare-associated infections and a significant cause of morbidity and mortality among older adult hospitalized patients. Due to extensive antibiotic usage, the number of CDIs has increased. Diagnosis of CDI is often difficult and has a substantial impact on the management of patients with the disease, mainly with regards to antibiotic management. The diagnosis of CDI is primarily based on the clinical signs and symptoms and is only confirmed by laboratory testing. Despite the high burden of CDI and the increasing interest in the disease, episodes of CDI are often misdiagnosed. The reasons for misdiagnosis are the lack of clinical suspicion or the use of inappropriate tests. The proper diagnosis of CDI reduces transmission, prevents inadequate or unnecessary treatments, and assures best antibiotic treatment. We review the options for the laboratory diagnosis of CDI within the settings of the most accepted guidelines for CDI diagnosis, treatment, and prevention of CDI.
Adrián Martínez-Meléndez, Licet Villarreal-Treviño, Departamento de Microbiología e Inmunología, Facultad de Ciencias Biológicas, Universidad Autónoma de Nuevo León. Pedro de Alba S/N, Ciudad Universitaria, San Nicolás de los Garza, Nuevo León 66450, Mexico.
Adrián
A
Martínez-Meléndez
Adrián Martínez-Meléndez, Licet Villarreal-Treviño, Departamento de Microbiología e Inmunología, Facultad de Ciencias Biológicas, Universidad Autónoma de Nuevo León. Pedro de Alba S/N, Ciudad Universitaria, San Nicolás de los Garza, Nuevo León 66450, Mexico.
Adrián
A
Camacho-Ortiz
Adrián Martínez-Meléndez, Licet Villarreal-Treviño, Departamento de Microbiología e Inmunología, Facultad de Ciencias Biológicas, Universidad Autónoma de Nuevo León. Pedro de Alba S/N, Ciudad Universitaria, San Nicolás de los Garza, Nuevo León 66450, Mexico.
Rayo
R
Morfin-Otero
Adrián Martínez-Meléndez, Licet Villarreal-Treviño, Departamento de Microbiología e Inmunología, Facultad de Ciencias Biológicas, Universidad Autónoma de Nuevo León. Pedro de Alba S/N, Ciudad Universitaria, San Nicolás de los Garza, Nuevo León 66450, Mexico.
Héctor Jesús
HJ
Maldonado-Garza
Adrián Martínez-Meléndez, Licet Villarreal-Treviño, Departamento de Microbiología e Inmunología, Facultad de Ciencias Biológicas, Universidad Autónoma de Nuevo León. Pedro de Alba S/N, Ciudad Universitaria, San Nicolás de los Garza, Nuevo León 66450, Mexico.
Licet
L
Villarreal-Treviño
Adrián Martínez-Meléndez, Licet Villarreal-Treviño, Departamento de Microbiología e Inmunología, Facultad de Ciencias Biológicas, Universidad Autónoma de Nuevo León. Pedro de Alba S/N, Ciudad Universitaria, San Nicolás de los Garza, Nuevo León 66450, Mexico.
Elvira
E
Garza-González
D000465:Algorithms; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000378:metabolism; D019411:Clinical Laboratory Techniques / Q000379:methods*; D016360:Clostridioides difficile; D003015:Clostridium Infections / Q000175:diagnosis / Q000382:microbiology*; D003428:Cross Infection / Q000175:diagnosis; D003967:Diarrhea / Q000175:diagnosis / Q000382:microbiology*; D004761:Enterocolitis, Pseudomembranous / Q000175:diagnosis / Q000382:microbiology*; D005969:Glutamate Dehydrogenase / Q000378:metabolism; D006760:Hospitalization; D006801:Humans; D007124:Immunoenzyme Techniques; D017410:Practice Guidelines as Topic; D012307:Risk Factors
D000900:Anti-Bacterial Agents; D015415:Biomarkers; D005969:Glutamate Dehydrogenase
Clostridium difficile; Diagnosis; Enzyme immunoassay; Glutamate dehydrogenase; Nucleic acid amplification tests; Toxigenic culture