Clostridioides difficile PCR Tcdb Cycle Threshold predicts toxin EIA positivity but not severity of infection

IF 2.5 3区生物学 Q3 MICROBIOLOGY

Anaerobe Pub Date : 2023-08-01 DOI:10.1016/j.anaerobe.2023.102755

Regan Mah , Kerstin Locher , Theodore S. Steiner , Aleksandra Stefanovic

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引用次数: 0

Abstract

Background

Diagnosis of Clostridioides difficile Infection (CDI) entails compatible clinical presentation and laboratory findings. We evaluated real-time polymerase chain reaction (qPCR) cycle threshold (C_T) as a predictor for disease severity and TcdB enzyme immunoassay (EIA) results.

Methods

Inpatients or emergency department patients who tested positive for tcdB gene by PCR were evaluated. Patients’ stools underwent testing for GDH and TcdA/B by EIA. Medical health records were reviewed for demographic, clinical presentation, laboratory, treatment and outcome data. Severity of CDI was calculated using various severity score indexes.

Results

The median C_T of cases was 32.05 ± 5.45. The optimal cut-off for predicting toxin EIA positivity and severe CDI based on chart review was 32.6 and 29.8, respectively, with the area under the receiver operator characteristics curve (AUC) of 0.74 and 0.60 respectively.

Conclusion

C_T value was an acceptable predictor for EIA toxin but less so for clinical severity. Our study potentially supports a diagnostic algorithm including C_T value to reduce the number of EIA toxin assays performed.

查看原文本刊更多论文

艰难梭菌PCR Tcdb循环阈值预测毒素EIA阳性，但不预测感染的严重程度。

背景：艰难梭菌感染（CDI）的诊断需要兼容的临床表现和实验室结果。我们评估了实时聚合酶链式反应（qPCR）循环阈值（CT）作为疾病严重程度和TcdB酶免疫测定（EIA）结果的预测指标。方法：对经PCR检测tcdB基因阳性的住院或急诊病人进行检测。通过EIA对患者的粪便进行GDH和TcdA/B检测。对医疗健康记录进行了人口统计学、临床表现、实验室、治疗和结果数据审查。CDI的严重程度使用各种严重程度评分指数进行计算。结果：病例中位CT值为32.05±5.45。基于图表审查，预测毒素EIA阳性和严重CDI的最佳截止值分别为32.6和29.8，受试者-操作者特征曲线下面积（AUC）分别为0.74和0.60。结论：CT值是一个可接受的预测EIA毒素的指标，但对临床严重程度的预测作用较弱。我们的研究可能支持一种包括CT值的诊断算法，以减少进行EIA毒素检测的次数。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Anaerobe 生物-微生物学

CiteScore

5.20

自引率

8.70%

发文量

137

审稿时长

76 days

期刊介绍： Anaerobe is essential reading for those who wish to remain at the forefront of discoveries relating to life processes of strictly anaerobes. The journal is multi-disciplinary, and provides a unique forum for those investigating anaerobic organisms that cause infections in humans and animals, as well as anaerobes that play roles in microbiomes or environmental processes. Anaerobe publishes reviews, mini reviews, original research articles, notes and case reports. Relevant topics fall into the broad categories of anaerobes in human and animal diseases, anaerobes in the microbiome, anaerobes in the environment, diagnosis of anaerobes in clinical microbiology laboratories, molecular biology, genetics, pathogenesis, toxins and antibiotic susceptibility of anaerobic bacteria.