Testing algorithm in clostridium difficile infection

Anotace: The aim of the study was to show that the multi-step algorithm contributes to fast and more accurate diagnostics and enables to start an early treatment of C.difficile infection (CDI). Materials for the study was 2,894 stool samples suspected of having CDI, were analyzed retrospectively. The biological samples from a nearby region were tested by different testing methods in Klinicka Biochemia laboratory in Zilina. The laboratory diagnosis was performed according to two- or three- step algorithm. The cultivation methods and identification of C.dificille strains by MALDI-TOF MS was performed. Most of the samples suspected of CDI could be assessed as negative within the applied two-step algorithm. In discordant results – samples with GDH positive and toxins A/B negative results were tested by further methods with higher sensitivity - ELISA test and the real-time PCR method in three-strp algorithm. The most positive results were from the departments of internal medicine and long-term-care patients over 60 years of age. Seasonality has shown a slight increase in positivity in the spring and autumn months, especially in 2015. The algorithm contributed to increasing the accuracy of the CDI suspect samples to reduce morbidity and mortality as well as the economic burden on CDI.