Medical College of Wisconsin
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Effective utilization of C. difficile PCR and identification of clinicopathologic factors associated with conversion to a positive result in symptomatic patients. Diagn Microbiol Infect Dis 2018 Apr;90(4):307-310

Date

01/02/2018

Pubmed ID

29290473

DOI

10.1016/j.diagmicrobio.2017.11.021

Scopus ID

2-s2.0-85039550113 (requires institutional sign-in at Scopus site)   1 Citation

Abstract

OBJECTIVES: We assess the diagnostic yield of repeat testing for C. difficile using molecular methods within 7days of a negative test and identify specific factors associated with conversion from negative to positive test result within a 7-day period to aid in selective test utilization.

METHODS: A retrospective chart review of 20,866 laboratory test orders for C. difficile PCR was conducted. The test result, clinicopathologic patient features, and previous test results were recorded. Univariate and multivariate analysis was conducted to compare patients with initial and repeat negative results (n=248) to a group of patients with conversion from negative to positive results within 7days.

RESULTS: Univariate analysis demonstrated a history of C. difficile infection, receipt of antibiotics within 14days, and duration of hospital stay as factors significantly different between patients with repeat negative and conversion to positive C. difficile test result. Only history of C. difficile infection was significantly different upon multivariate analysis.

CONCLUSIONS: Identification of prior C. difficile infection as the only factor significantly correlated with conversion from negative to positive C. difficile test result within 7days aids in selective test utilization and reduces the costs associated with unnecessary laboratory testing.

Author List

Mostafa ME, Flynn T, Hartley CP, Ledeboer NA, Buchan BW

Authors

Blake W. Buchan PhD Professor in the Pathology department at Medical College of Wisconsin
Nathan A. Ledeboer PhD Chief, Professor in the Pathology department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Aged
Clostridium Infections
Decision Support Techniques
Female
Humans
Male
Medical History Taking
Middle Aged
Molecular Diagnostic Techniques
Polymerase Chain Reaction
Retrospective Studies