Next Article in Journal
Inhibitor of DNA-Binding/Differentiation Proteins and Environmental Toxicants: Genomic Impact on the Onset of Depressive Dysfunction
Previous Article in Journal
Spotlight on the Transglutaminase 2-Heparan Sulfate Interaction
Open AccessArticle

Effectiveness of a Two-Step Testing Algorithm for Reliable and Cost-Effective Detection of Clostridium difficile Infection in a Tertiary Care Hospital in Saudi Arabia

Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Center, Jeddah 21499, Saudi Arabia
*
Author to whom correspondence should be addressed.
Med. Sci. 2019, 7(1), 6; https://doi.org/10.3390/medsci7010006
Received: 9 September 2018 / Revised: 21 December 2018 / Accepted: 27 December 2018 / Published: 8 January 2019
The aim of this study was to evaluate the effectiveness of a two-step algorithm for the detection of Clostridium difficile infection. Setting and Design: A two-step testing algorithm was evaluated for testing stool samples from patients suspected of Clostridium difficile infection (CDI). A total of 103 stool specimens were tested using the C. diff Quik Chek Complete enzyme immunoassay (EIA) test and the Xpert C. difficile PCR test. A two-step algorithm was implemented, and data from 3518 patient samples tested during a two-year period after implementation were analyzed to evaluate the effectiveness. The sensitivity, specificity, and positive and negative predictive values (PPV, NPV) of the Quik Chek Complete EIA test were calculated using the Xpert C. difficile PCR test as a reference method. The sensitivity, specificity, PPV, and NPV of the Quik Chek Complete EIA test for C. difficile toxin were 46.7%, 100%, 100%, and 91%, respectively. The two-step algorithm, which combined the Quik Chek Complete EIA with Xpert C. difficile PCR, improved the sensitivity and also provided rapid detection. When algorithm-based testing was performed daily, there was a 66% reduction in turnaround time compared to batch testing using a lengthy ELISA procedure. Postimplementation data analysis showed that almost 89% of the samples could be reported immediately by initial screening with Quik Chek Complete EIA. Only 11% of the samples gave discrepant results and required PCR confirmation. According to our results, the two-step algorithm is an effective tool for the rapid and reliable detection of toxigenic C. difficile from stool samples. View Full-Text
Keywords: antibiotic-associated diarrhea; Clostridium difficile toxin; enzyme immunoassay; polymerase chain reaction; algorithm-based testing; glutamate dehydrogenase antigen; nucleic acid testing antibiotic-associated diarrhea; Clostridium difficile toxin; enzyme immunoassay; polymerase chain reaction; algorithm-based testing; glutamate dehydrogenase antigen; nucleic acid testing
Show Figures

Figure 1

MDPI and ACS Style

Qutub, M.; Govindan, P.; Vattappillil, A. Effectiveness of a Two-Step Testing Algorithm for Reliable and Cost-Effective Detection of Clostridium difficile Infection in a Tertiary Care Hospital in Saudi Arabia. Med. Sci. 2019, 7, 6.

Show more citation formats Show less citations formats
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.

Article Access Map by Country/Region

1
Back to TopTop