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Clinical outcomes and treatment necessity in patients with toxin-negative Clostridioides difficile stool samples.
Cho, Dae Hyeon; Kim, Si-Ho; Jeon, Cheon Hoo; Kim, Hyoung Tae; Park, Kyoung-Jin; Kim, Junyoung; Kwak, Jiyeong; Kwan, Byung Soo; Kong, Sungmin; Lee, Jung Won; Kim, Kwang Min; Wi, Yu Mi.
Afiliación
  • Cho DH; Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.
  • Kim SH; Division of Infectious Diseases, Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, 50 Hapseong-dong, Masanhoewon-gu, Changwon-si, 51353, Gyeongsangnam-do, Republic of Korea.
  • Jeon CH; Division of Infectious Diseases, Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, 50 Hapseong-dong, Masanhoewon-gu, Changwon-si, 51353, Gyeongsangnam-do, Republic of Korea.
  • Kim HT; Department of Laboratory Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea.
  • Park KJ; Department of Laboratory Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea.
  • Kim J; Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.
  • Kwak J; Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.
  • Kwan BS; Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.
  • Kong S; Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.
  • Lee JW; Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.
  • Kim KM; Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.
  • Wi YM; Division of Infectious Diseases, Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, 50 Hapseong-dong, Masanhoewon-gu, Changwon-si, 51353, Gyeongsangnam-do, Republic of Korea. yumi.wi@samsung.com.
Ann Clin Microbiol Antimicrob ; 23(1): 35, 2024 Apr 25.
Article en En | MEDLINE | ID: mdl-38664689
ABSTRACT

PURPOSE:

The clinical significance of negative toxin enzyme immunoassays (EIA) for Clostridioides difficile infections (CDIs) is unclear. Our study aimed to investigate the significance of toxin EIA-negative in the diagnosis and prognosis of CDI.

METHODS:

All stool specimens submitted for C. difficile toxin EIA testing were cultured to isolate C. difficile. In-house PCR for tcdA, tcdB, cdtA, and cdtB genes were performed using C. difficile isolates. Stool specimens were tested with C. difficile toxins A and B using EIA kit (RIDASCREEN Clostridium difficile toxin A/B, R-Biopharm AG, Darmstadt, Germany). Characteristics and subsequent CDI episodes of toxin EIA-negative and -positive patients were compared.

RESULTS:

Among 190 C. difficile PCR-positive patients, 83 (43.7%) were toxin EIA-negative. Multivariate analysis revealed independent associations toxin EIA-negative results and shorter hospital stays (OR = 0.98, 95% CI 0.96-0.99, p = 0.013) and less high-risk antibiotic exposure in the preceding month (OR = 0.38, 95% CI 0.16-0.94, p = 0.035). Toxin EIA-negative patients displayed a significantly lower white blood cell count rate (11.0 vs. 35.4%, p < 0.001). Among the 54 patients who were toxin EIA-negative and did not receive CDI treatment, three (5.6%) were diagnosed with CDI after 7-21 days without complication.

CONCLUSION:

Our study demonstrates that toxin EIA-negative patients had milder laboratory findings and no complications, despite not receiving treatment. Prolonged hospitalisation and exposure to high-risk antibiotics could potentially serve as markers for the development of toxin EIA-positive CDI.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Proteínas Bacterianas / Toxinas Bacterianas / Clostridioides difficile / Infecciones por Clostridium / Heces Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Ann Clin Microbiol Antimicrob Asunto de la revista: MICROBIOLOGIA / TERAPIA POR MEDICAMENTOS Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Proteínas Bacterianas / Toxinas Bacterianas / Clostridioides difficile / Infecciones por Clostridium / Heces Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Ann Clin Microbiol Antimicrob Asunto de la revista: MICROBIOLOGIA / TERAPIA POR MEDICAMENTOS Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido