In this issue of Pediatrics , Cotter et al1 offer valuable analysis of the utility of molecular (nucleic acid amplification) enteric pathogen diagnostic technology in hospitalized children. These tests return highly worthwhile information for some infections, but many of their results are prone to misinterpretation. However, diagnostic guidelines based on classic microbiologic techniques do not perform well either.2 Molecular enteric microbiology is, therefore, a model opportunity for diagnostic stewardship to maximize worth and minimize wasteful expense. Cotter et al1 find that only 3.7% o...

Video Abstract OBJECTIVES: Many hospitals have transitioned from conventional stool diagnostics to rapid multiplex polymerase chain reaction gastrointestinal panels (GIP). The clinical impact of this testing has not been evaluated in children. In this study, we compare use, results, and patient outcomes between conventional diagnostics and GIP testing. METHODS: This is a multicenter cross-sectional study of children who underwent stool testing from 2013 to 2017. We used bivariate analyses to compare test use, results, and patient outcomes, including length of stay (LOS), ancillary testing, ...

With labs blinding a specific panel, a C diff diagnosis can be masked and missed.

Antibiotic-induced modulation of the intestinal microbiota can lead to Clostridioides difficile infection (CDI), which is associated with considerable morbidity, mortality, and healthcare-costs globally. Therefore, identification of markers predictive of CDI could substantially contribute to guiding …

This prognostic marker might not be an adequate reason to test for Clostridium difficile in hospitalized patients.

Video Abstract OBJECTIVES: Many hospitals have transitioned from conventional stool diagnostics to rapid multiplex polymerase chain reaction gastrointestinal panels (GIP). The clinical impact of this testing has not been evaluated in children. In this study, we compare use, results, and patient outcomes between conventional diagnostics and GIP testing. METHODS: This is a multicenter cross-sectional study of children who underwent stool testing from 2013 to 2017. We used bivariate analyses to compare test use, results, and patient outcomes, including length of stay (LOS), ancillary testing, ...

Typing methods are needed for epidemiological tracking of new emerging and hypervirulent strains because of the growing incidence, severity and mortality of Clostridioides difficile infections (CDI). The aim of this study was the evaluation of a typing Matrix-Assisted Desorption/Ionization-Ti …

Clostridium difficile infection (CDI) is a leading cause of healthcare-associated infections and the clinical spectrum ranges from asymptomatic colonization to toxic megacolon and fulminant colitis.

To study the association between detection of the Clostridioides difficile gene encoding the binary toxin (CDT) and direct detection of toxinB (TcdB) from feces with the appearance of serious disease, complications, or recurrence in a prospective series of cases. A total of 220 confirmed case …

Clostridioides difficile (CD) is a major nosocomial pathogen and the leading cause of antibiotic-associated diarrhoea. In light of the strong association between antimicrobial use and CD infections (CDI), it may be hypothesised that areas at higher prevalence of antimicrobial resistance, like the re …

Introduction: Gastrointestinal diseases due to infectious pathogens currently represent an important global health concern, especially in children and developing countries. Early and accurate detection of gastrointestinal pathogens is important to initiate the appropriate type of therapy. Mul …

CDI is a clinical diagnosis supported by laboratory findings. Together, clinical evaluation combined with diagnostic stewardship can optimize the accurate diagnosis of CDI.

Clostridioides difficile (Clostridium difficile) (CD) infection remains a challenging diagnosis in hospitalized patients given the myriad of testing procedures and array of alternative causes for diarrhea. We identified 100 consecutive inpatients with positive CD testing in a single tertiary center …

Clostridioides difficile (Clostridium difficile) (CD) infection remains a challenging diagnosis in hospitalized patients given the myriad of testing procedures and array of alternative causes for diarrhea. We identified 100 consecutive inpatients with positive CD testing in a single tertiary center …

The Korea Basic Science Institute (KBSI) said its researchers have developed a fast test kit that detects antibiotic-resistant super bacteria, Clostridioides Difficile (C.Difficile). The researcher...

The change in guidelines address how to assess damage to the kidneys caused by fluid loss associated with severe C. diff infection.

“A high or rising white blood cell count in isolation is not a sufficient indication for C diff infection testing,” the study authors said.

Missed diagnosis resulted in delays in initiation of therapy and hospital re-admissions.

A panel of clinicians recognize the challenges associated with screening patients for the C. difficile infection and highlight factors that should prompt someone for an evaluation.  

Types of testing algorithms used in clinical practice to help clarify a diagnosis of C difficile infection.  

Important things to understand about diagnosing C. difficile and recommendations for properly differentiating the condition from other diseases when working-up a patient.

Nearly half of all CDI orders were inappropriate among hospitalized patients, and an additional 24% of test results never returned. Provider- and patient-level risk factors included type of provider, specific hospital units, and signs of sepsis.