PMID- 25122866
OWN - NLM
STAT- MEDLINE
DCOM- 20151012
LR  - 20211021
IS  - 1098-660X (Electronic)
IS  - 0095-1137 (Print)
IS  - 0095-1137 (Linking)
VI  - 52
IP  - 11
DP  - 2014 Nov
TI  - Clinical characteristics of patients who test positive for Clostridium difficile 
      by repeat PCR.
PG  - 3853-5
LID - 10.1128/JCM.01659-14 [doi]
AB  - The high sensitivity of PCR assays for diagnosing Clostridium difficile infection 
      (CDI) has greatly reduced the need for repeat testing after a negative result. 
      Nevertheless, a small subset of patients do test positive within 7 days of a 
      negative test. The aim of this study was to evaluate the clinical characteristics 
      of these patients to determine when repeat testing may be appropriate. The 
      results of all Xpert C. difficile PCR (Cepheid, Sunnyvale CA) tests performed in 
      the clinical microbiology laboratory at New York-Presbyterian Hospital, Columbia 
      University Medical Center (NYPH/CUMC) from 1 May 2011 through 6 September 2013, 
      were reviewed. A retrospective case-control study was performed, comparing 
      patients who tested positive within 7 days of a negative test result to a random 
      selection of 50 controls who tested negative within 7 days of a negative test 
      result. During the study period, a total of 14,875 tests were performed, of which 
      1,066 were repeat tests (7.2%). Eleven of these repeat tests results were 
      positive (1.0%). The only risk factor independently associated with repeat 
      testing positive was history of a prior CDI (odds ratio [OR], 19.6 [95% 
      confidence interval CI, 4.0 to 19.5], P < 0.001). We found that patients who 
      test positive for C. difficile by PCR within 7 days of a negative test are more 
      likely to have a history of CDI than are patients who test negative with repeat 
      PCR. This finding may be due to the high rate of disease relapse or the increased 
      likelihood of empirical therapy leading to false-negative results in these 
      patients.
CI  - Copyright (c) 2014, American Society for Microbiology. All Rights Reserved.
FAU - Green, Daniel A
AU  - Green DA
AD  - Department of Pathology and Cell Biology, Columbia University College of 
      Physicians and Surgeons, New York, New York, USA dag2149@columbia.edu.
FAU - Stotler, Brie
AU  - Stotler B
AD  - Department of Pathology and Cell Biology, Columbia University College of 
      Physicians and Surgeons, New York, New York, USA.
FAU - Jackman, Dana
AU  - Jackman D
AD  - Clinical Microbiology Service, Columbia University Medical Center, New 
      York-Presbyterian Hospital, New York, New York, USA.
FAU - Whittier, Susan
AU  - Whittier S
AD  - Department of Pathology and Cell Biology, Columbia University College of 
      Physicians and Surgeons, New York, New York, USA Clinical Microbiology Service, 
      Columbia University Medical Center, New York-Presbyterian Hospital, New York, New 
      York, USA.
FAU - Della-Latta, Phyllis
AU  - Della-Latta P
AD  - Department of Pathology and Cell Biology, Columbia University College of 
      Physicians and Surgeons, New York, New York, USA Clinical Microbiology Service, 
      Columbia University Medical Center, New York-Presbyterian Hospital, New York, New 
      York, USA.
LA  - eng
PT  - Journal Article
DEP - 20140813
PL  - United States
TA  - J Clin Microbiol
JT  - Journal of clinical microbiology
JID - 7505564
SB  - IM
MH  - Academic Medical Centers
MH  - Case-Control Studies
MH  - Clostridioides difficile/genetics/*isolation & purification
MH  - Clostridium Infections/*diagnosis/epidemiology/microbiology/*pathology
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - New York City/epidemiology
MH  - Polymerase Chain Reaction/*methods
MH  - Retrospective Studies
MH  - Risk Factors
PMC - PMC4313214
EDAT- 2014/08/15 06:00
MHDA- 2015/10/13 06:00
PMCR- 2015/05/01
CRDT- 2014/08/15 06:00
PHST- 2014/08/15 06:00 [entrez]
PHST- 2014/08/15 06:00 [pubmed]
PHST- 2015/10/13 06:00 [medline]
PHST- 2015/05/01 00:00 [pmc-release]
AID - JCM.01659-14 [pii]
AID - 01659-14 [pii]
AID - 10.1128/JCM.01659-14 [doi]
PST - ppublish
SO  - J Clin Microbiol. 2014 Nov;52(11):3853-5. doi: 10.1128/JCM.01659-14. Epub 2014 
      Aug 13.