2018 IDSA/SHEA C. difficile Guideline Authors Stress the Importance of Multistep Algorithm Testing
Mark H. Wilcox, MD, FRCPath, a consultant and the head of microbiology research and development at Leeds Teaching Hospitals NHS Trust, in England, said the United Kingdom also has changed its protocols for testing. “We have changed the recommendation for CDI laboratory diagnosis to highlight that the best-performing method (i.e., positive and negative predictive value) for detecting patients with clinically significant C. difficile infection is a stool toxin test as part of a multistep algorithm, rather than a nucleic acid amplification test [NAAT] alone. Current U.S. practice frequently involves use of NAAT alone. We now know that the latter approach, while a sensitive method, can lead to overdiagnosis of CDI,” said Dr. Wilcox, who was asked about the new guidelines.
“We think these tests are probably picking up patients who have been colonized with C. diff, then have a diarrheal episode due to another cause,” Dr. Gerding said.
Read the full document in Gastroenterology & Endoscopy News: New C. difficile Guidelines