Author/Editor     Barbut, F; Delmee, M; Brazier, JS; Petit, JC; Poxton, IR; Rupnik, M; Lalande, V; Schneider, C; Mastrantonio, P; Alonso, R
Title     A European survey of diagnostic methods and testing protocols for Clostridium difficiel
Type     članek
Source     Clin Microbiol Infect
Vol. and No.     Letnik 9, št. 10
Publication year     2003
Volume     str. 989-96
Language     eng
Abstract     Objective To conduct a survey of the methods used in clinical microbiology laboratories in Europe to diagnose infection with Clostridium difficile. Methods A questionnaire was devised and sent to a co-ordinating member of the Study Group in each of eight European countries. This co-ordinator was in charge of forwarding the questionnaire to hospital laboratories arbitrarily selected. The number of laboratories in each country was determined on the basis of one laboratory for 10,000 beds of hospitalization. This questionnaire covered different aspects pertaining to Clostridium difficile associated to diarrhea (CDAD) diagnosis such as circumstances of request, criteria used for undertaking C. difficile investigations, methods used for the diagnosis, etc. Results A total of 212 questionnaires were completed and submitted for analysis: 87.7% of laboratories reported routinely performing C. difficile diagnostic tests. Methods used included toxin detection (93%), culture (55%), and glutamate dehydrogenase (GDH) detection (5.9%). Among the laboratories detecting toxins, different enzyme immunoassays (EIA) and cytotoxicity assays were used in 79% and 17.3% of cases, respectively. Among the different strategies reported, 4.8% were considered suboptimal for the diagnosis of C. difficile infections, but marked discrepancies could be observed between countries. The overall incidence (median) of CDAD was estimated at 1.1 for 1,000 patient admissions. Conclusion The results of this study suggest marked discrepancies between laboratories and also between countries regarding the criteria by which C. difficile is investigated for, and the methods and the strategies that are used for the diagnosis of C. difficile. These discrepancies could be explained by the lack of clear guidelines for C. difficile diagnosis in each country, and by the importance that physicians attach to C. difficile. (Abstract truncated at 2000 characters).
Descriptors     BACTERIAL PROTEINS
BACTERIAL TOXINS
CLOSTRIDIUM INFECTIONS
CLOSTRIDIUM DIFFICILE
DIARRHEA
EUROPE
REAGENT KITS, DIAGNOSTIC
QUESTIONNAIRES
IMMUNOENZYME TECHNIQUES
FECES
ENTEROTOXINS
GLUTAMATE DEHYDROGENASE