Clinical outcomes and treatment necessity in patients with toxin-negative Clostridioides difficile stool samples.
Humans
Clostridioides difficile
/ genetics
Feces
/ microbiology
Male
Female
Bacterial Toxins
/ analysis
Clostridium Infections
/ diagnosis
Aged
Middle Aged
Bacterial Proteins
/ genetics
Enterotoxins
/ analysis
Aged, 80 and over
Anti-Bacterial Agents
/ therapeutic use
Immunoenzyme Techniques
Adult
Treatment Outcome
Polymerase Chain Reaction
Prognosis
Clostridioides difficile
Enzyme immunoassay
Polymerase chain reaction
Toxin EIA-negative CDI
Toxin EIA-positive CDI
Journal
Annals of clinical microbiology and antimicrobials
ISSN: 1476-0711
Titre abrégé: Ann Clin Microbiol Antimicrob
Pays: England
ID NLM: 101152152
Informations de publication
Date de publication:
25 Apr 2024
25 Apr 2024
Historique:
received:
20
01
2024
accepted:
12
04
2024
medline:
26
4
2024
pubmed:
26
4
2024
entrez:
25
4
2024
Statut:
epublish
Résumé
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. 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. 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. 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.
Identifiants
pubmed: 38664689
doi: 10.1186/s12941-024-00696-1
pii: 10.1186/s12941-024-00696-1
doi:
Substances chimiques
Bacterial Toxins
0
Bacterial Proteins
0
Enterotoxins
0
Anti-Bacterial Agents
0
toxB protein, Clostridium difficile
0
tcdA protein, Clostridium difficile
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
35Subventions
Organisme : 'Songcheon Medical Research Fund', Sungkyunkwan University.
ID : 2022
Informations de copyright
© 2024. The Author(s).
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