Rapid and accurate diagnosis of Clostridium difficile infection by real-time polymerase chain reaction

• Published in: Intestinal research Vol. 16; no. 1; pp. 109 - 115
• Main Authors: Song, Pil Hun, Min, Jung Hwa, Kim, You Sun, Jo, Soo Yeon, Kim, Eun Jin, Lee, Kyung Jin, Lee, Jeonghun, Sung, Hyun, Moon, Jeong Seop, Whang, Dong Hee
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Association for the Study of Intestinal Diseases 01.01.2018; 대한장연구학회
• Subjects: Original; 내과학; Polymerase chain reaction; Clostridium difficile infection; Diagnostic method
• ISSN: 1598-9100; 2288-1956
• DOI: 10.5217/ir.2018.16.1.109

The incidence and severity of infection (CDI) have increased worldwide, resulting in a need for rapid and accurate diagnostic methods. A retrospective study was conducted to compare CDI diagnosis methods between January 2014 and December 2014. The stool samples, which were obtained in presumptive CDI patients, were compared for their diagnostic accuracy and rapidity, including real-time polymerase chain reaction (PCR) of toxin genes, toxin assay, and culture for . A total of 207 cases from 116 patients were enrolled in this study and 117 cases (56.5%) were diagnosed as having CDI. Among the 117 cases, the sensitivities of real-time PCR, toxin assay, and culture for were 87.2% (102 cases; 95% CI, 80.7%-92.8%), 48.7% (57 cases; 95% CI, 41.0%-59.8%), and 65.0% (76 cases; 95% CI, 60.2%-78.5%), respectively ( <0.005). Notably, 34 cases (29.0%) were diagnosed with CDI by real-time PCR only. The time required to obtain results was 2.27 hours (136.62±82.51 minutes) for real-time PCR, 83.67 hours (5,020.66±3,816.38 minutes) for toxin assay, and 105.79 hours (6,347.68±3,331.46 minutes) for culture ( <0.005), respectively. We confirmed that real-time PCR of toxin genes is the most effective diagnostic method for accurate and early diagnosis of CDI. It also helps to diagnose hypervirulent CDI, such as ribotype 027 infection.