Repeated enzyme immunoassays have limited utility in diagnosing Clostridium difficile

European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology
M DreesC E O'Sullivan

Abstract

Many clinical laboratories use enzyme immunoassays (EIA) to diagnose Clostridium difficile-associated disease (CDAD). Clinicians frequently order three EIAs to "rule out" CDAD. We performed a retrospective cohort study to determine the clinical utility of repeating EIA testing to diagnose CDAD. We reviewed all EIAs performed by our laboratory during 2005, determined the total number of tests per patient and per testing episode, and calculated the relative negative predictive value (NPV) of one EIA compared to > or =2 EIAs. The laboratory performed 2,938 EIAs, of which 253 (8.6%) tests were positive. Most patients (85%) were diagnosed by the first EIA performed. Of >1,000 testing episodes that included > or =2 EIAs within 7 days, only 15 patients had a positive second or third test after negative initial testing. The relative NPV of the first EIA was 97.4%. These data suggest that using newer generation EIAs, repeated testing is of limited benefit in diagnosing CDAD.

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Citations

Jun 2, 2011·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Anna M Kufelnicka, Thomas J Kirn
Oct 7, 2010·Current Medical Research and Opinion·Abhishek DeshpandeAnil Jain
Jul 5, 2011·The Journal of Hospital Infection·S D Goldenberg, G L French
Jun 4, 2011·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Abhishek DeshpandeDavid D K Rolston
Jun 2, 2010·Clinics in Laboratory Medicine·Scott Curry
Nov 26, 2009·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·M J T CrobachE J Kuijper
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Apr 16, 2009·The American Journal of Gastroenterology·Hashim NematGisele Wolf-Klein
Mar 26, 2021·Current Infectious Disease Reports·Frances J BolyJennie H Kwon

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