Regan Mah , Kerstin Locher , Theodore S. Steiner , Aleksandra Stefanovic
{"title":"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。","authors":"Regan Mah , Kerstin Locher , Theodore S. Steiner , Aleksandra Stefanovic","doi":"10.1016/j.anaerobe.2023.102755","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Diagnosis of <span><em>Clostridioides difficile</em><em> Infection</em></span> (CDI) entails compatible clinical presentation and laboratory findings. We evaluated real-time polymerase chain reaction (qPCR) cycle threshold (C<sub>T</sub>) as a predictor for disease severity and TcdB enzyme immunoassay (EIA) results.</p></div><div><h3>Methods</h3><p><span>Inpatients or emergency department patients who tested positive for </span><em>tcdB</em><span> gene by PCR were evaluated. Patients’ stools underwent testing for GDH<span> 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.</span></span></p></div><div><h3>Results</h3><p>The median C<sub>T</sub> 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.</p></div><div><h3>Conclusion</h3><p>C<sub>T</sub> value was an acceptable predictor for EIA toxin but less so for clinical severity. Our study potentially supports a diagnostic algorithm including C<sub>T</sub> value to reduce the number of EIA toxin assays performed.</p></div>","PeriodicalId":8050,"journal":{"name":"Anaerobe","volume":null,"pages":null},"PeriodicalIF":2.5000,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Clostridioides difficile PCR Tcdb Cycle Threshold predicts toxin EIA positivity but not severity of infection\",\"authors\":\"Regan Mah , Kerstin Locher , Theodore S. Steiner , Aleksandra Stefanovic\",\"doi\":\"10.1016/j.anaerobe.2023.102755\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Diagnosis of <span><em>Clostridioides difficile</em><em> Infection</em></span> (CDI) entails compatible clinical presentation and laboratory findings. We evaluated real-time polymerase chain reaction (qPCR) cycle threshold (C<sub>T</sub>) as a predictor for disease severity and TcdB enzyme immunoassay (EIA) results.</p></div><div><h3>Methods</h3><p><span>Inpatients or emergency department patients who tested positive for </span><em>tcdB</em><span> gene by PCR were evaluated. Patients’ stools underwent testing for GDH<span> 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.</span></span></p></div><div><h3>Results</h3><p>The median C<sub>T</sub> 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.</p></div><div><h3>Conclusion</h3><p>C<sub>T</sub> value was an acceptable predictor for EIA toxin but less so for clinical severity. Our study potentially supports a diagnostic algorithm including C<sub>T</sub> value to reduce the number of EIA toxin assays performed.</p></div>\",\"PeriodicalId\":8050,\"journal\":{\"name\":\"Anaerobe\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2023-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Anaerobe\",\"FirstCategoryId\":\"99\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1075996423000641\",\"RegionNum\":3,\"RegionCategory\":\"生物学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"MICROBIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Anaerobe","FirstCategoryId":"99","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1075996423000641","RegionNum":3,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MICROBIOLOGY","Score":null,"Total":0}
Clostridioides difficile PCR Tcdb Cycle Threshold predicts toxin EIA positivity but not severity of infection
Background
Diagnosis of Clostridioides difficile Infection (CDI) entails compatible clinical presentation and laboratory findings. We evaluated real-time polymerase chain reaction (qPCR) cycle threshold (CT) 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 CT 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
CT value was an acceptable predictor for EIA toxin but less so for clinical severity. Our study potentially supports a diagnostic algorithm including CT value to reduce the number of EIA toxin assays performed.
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.
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