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Evaluation of the Usefulness of GDH & Toxin Test for the Diagnosis of Clostridioides difficile in a Tertiary Hospital in Seoul

Biomedical Science Letters 2020년 26권 3호 p.210 ~ 216
주호중, 김상하, 권필승, 류재기, 육근돌, 유영빈, 김영권,
소속 상세정보
주호중 ( Joo Ho-Joong ) - Samsung Medical Center Department of Laboratory Medicine
김상하 ( Kim Sang-Ha ) - Konyang University Hospital Department of Laboratory Medicine
권필승 ( Kwon Pil-Seung ) - Wonkwang Health Science University Department of Clinical Laboratory Science
류재기 ( Ryu Jae-Ki ) - Gimcheon University Department of Biomedical Laboratory Science
육근돌 ( Yook Keun-Dol ) - Daejeon Health Institute of Technology Department of Clinical Laboratory Science
유영빈 ( Yu Young-Bin ) - Konyang University College of Medical Science Department of Biomedical Laboratory Science
김영권 ( Kim Young-Kwon ) - Konyang University Graduate School Department of Health Sciences

Abstract


The purpose of this study was to evaluate GDH & Toxin (GDT) tests for the identification of the presence of Clostridioides difficile (C. difficile) as well as to detect whether any toxin was present in the feces of patients suspected of diarrhea associated with C. difficile. Data related to the results of toxin and culture (TC) tests and GDT tests conducted on patients with diarrhea and suspected CDI between January 2017 and august 2018, positive test rates, patient ages and sexes, whether the patients were hospitalized, and turnaround time (TAT) were analyzed retrospectively. Of the 7,554 total tests conducted for CDI diagnosis, 1,010 TC tests (14.9%) were positive, while 92 GDT tests (12.0%) were positive. Of these positive cases, 815 (80.7%) identified through TC test and 80 (87%) identified through GDT test were inpatients. also, among the patients with positive test results, 497 (49.2%) diagnosed through TC test and 45 (48.9%) diagnosed through GDT test were aged 61 years or older. The total time required to complete a TC test was 83.6 hours, while the time required for a GDT test was 11.2 hours, equating to an approximately three-day difference between the two tests. The detection of toxin-producing C. difficile is important in CDI diagnosis, but the commonly used Enzymeimmunoassay (EIA) toxin tests with low sensitivity result in delayed CDI diagnosis time. Therefore, primary screening tests for CDI diagnosis using the GDT method and secondary tests using additional methods are considered most effective.

키워드

C. difficile; Toxigenic culture; AAD; CDI; ASM; GDH

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