PMID- 23527018
OWN - NLM
STAT- MEDLINE
DCOM- 20130920
LR  - 20211021
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 8
IP  - 3
DP  - 2013
TI  - Confocal laser endomicroscopy for in vivo diagnosis of Clostridium difficile 
      associated colitis - a pilot study.
PG  - e58753
LID - 10.1371/journal.pone.0058753 [doi]
LID - e58753
AB  - BACKGROUND: Clostridium difficile infection (CDI) is one of the most dreaded 
      causes of hospital-acquired diarrhea. Main objective was to investigate whether 
      confocal laser endomicroscopy (CLE) has the capability for in vivo diagnosis of 
      C. difficile associated histological changes. Second objective was to prove the 
      presence of intramucosal bacteria using CLE. METHODS: 80 patients were 
      prospectively included, 10 patients were diagnosed with CDI based on toxigenic 
      culture. To validate the presence of intramucosal bacteria ex vivo, CLE was 
      performed in pure C. difficile culture; additionally fluorescence in situ 
      hybridization (FISH) was performed. Finally, CLE with fluorescence labelled 
      oligonucleotide probe specific for C. difficile was performed ex vivo in order to 
      prove the presence of bacteria. RESULTS: CLE identified CDI-associated 
      histological changes in vivo (sensitivity and accuracy of 88.9% and 96.3%). In 
      addition, intramucosal bacteria were visualized. The presence of these bacteria 
      could be proven by CLE with labeled, specific molecular C. difficile probe and 
      FISH-technique. Based on comparison between CLE and FISH analyses, sensitivity 
      and specificity for the presence of intramucosal bacteria were 100%. CONCLUSION: 
      CLE has the potential for in vivo diagnosis of CDI associated colitis. In 
      addition, CLE allowed the detection of intramucosal bacteria in vivo.
FAU - Neumann, Helmut
AU  - Neumann H
AD  - Department of Medicine I, University of Erlangen-Nuremberg, Erlangen, Germany. 
      helmut.neumann@uk-erlangen.de
FAU - Gunther, Claudia
AU  - Gunther C
FAU - Vieth, Michael
AU  - Vieth M
FAU - Grauer, Martin
AU  - Grauer M
FAU - Wittkopf, Nadine
AU  - Wittkopf N
FAU - Mudter, Jonas
AU  - Mudter J
FAU - Becker, Christoph
AU  - Becker C
FAU - Schoerner, Christoph
AU  - Schoerner C
FAU - Atreya, Raja
AU  - Atreya R
FAU - Neurath, Markus F
AU  - Neurath MF
LA  - eng
PT  - Journal Article
DEP - 20130319
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - *Clostridioides difficile/genetics/isolation & purification
MH  - Colonoscopy/methods
MH  - Enterocolitis, Pseudomembranous/*diagnosis/microbiology
MH  - Female
MH  - Humans
MH  - In Situ Hybridization, Fluorescence
MH  - Intestinal Mucosa/microbiology
MH  - Male
MH  - Microscopy, Confocal/*methods
MH  - Middle Aged
MH  - Pilot Projects
MH  - Prospective Studies
PMC - PMC3602426
COIS- Competing Interests: The authors have declared that no competing interests exist.
EDAT- 2013/03/26 06:00
MHDA- 2013/09/21 06:00
PMCR- 2013/03/19
CRDT- 2013/03/26 06:00
PHST- 2012/09/26 00:00 [received]
PHST- 2013/02/06 00:00 [accepted]
PHST- 2013/03/26 06:00 [entrez]
PHST- 2013/03/26 06:00 [pubmed]
PHST- 2013/09/21 06:00 [medline]
PHST- 2013/03/19 00:00 [pmc-release]
AID - PONE-D-12-29618 [pii]
AID - 10.1371/journal.pone.0058753 [doi]
PST - ppublish
SO  - PLoS One. 2013;8(3):e58753. doi: 10.1371/journal.pone.0058753. Epub 2013 Mar 19.