ArticleJournal of clinical microbiology2010
Clostridium difficile testing in the clinical laboratory by use of multiple testing algorithms.
Article in Journal of clinical microbiology, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 79 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
79 citing papers in PubMed, 5 syntheses or guidelines pooled it, 223 citations in OpenAlex.
- Evaluation of the Cepheid Xpert C. difficile diagnostic assay: an update meta-analysis.Brazilian journal of microbiology : [publication of the Brazilian Society for Microbiology] · 2021Pooled it
- Recommendations for the diagnosis and treatment of Clostridioides difficile infection: An official clinical practice guideline of the Spanish Society of Chemotherapy (SEQ), Spanish Society of Internal Medicine (SEMI) and the working group of Postoperative Infection of the Spanish Society of Anesthesia and Reanimation (SEDAR).Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2020Guideline
- A Laboratory Medicine Best Practices Systematic Review and Meta-analysis of Nucleic Acid Amplification Tests (NAATs) and Algorithms Including NAATs for the Diagnosis ofClinical microbiology reviews · 2019Pooled it
- Accuracy of Xpert Clostridium difficile assay for the diagnosis of Clostridium difficile infection: A meta analysis.PloS one · 2017Pooled it
- Molecular techniques for diagnosis of Clostridium difficile infection: systematic review and meta-analysis.Mayo Clinic proceedings · 2012Pooled it
- Trends in Clostridioides Difficile Hospitalisations in Ireland (2009-2022).Irish journal of medical science · 2026Article
- Evaluation of three commercial rapid immunoassays for the diagnosis ofMicrobiology spectrum · 2025Article
- Development of a toxin-selective immunotracer for in vivo detection of Clostridioides difficile infection by immunoPET.EJNMMI radiopharmacy and chemistry · 2025Article
- Pseudomembranous colitis and Parabacteroides distasonis bacteraemia: a rare clinical presentation.Clinical journal of gastroenterology · 2024Article
- A Rare Case of Polymerase Chain Reaction-Negative Severe Clostridioides difficile Infection.Cureus · 2023Article
- Clostridioides difficile Infection in Pediatric Inflammatory Bowel Disease.Current gastroenterology reports · 2023Review
- Overview of current detection methods and microRNA potential inWorld journal of gastroenterology · 2023Review
- Article
- Significance of a polymerase chain reaction method in the detection of Clostridioides difficile.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2021Article
- Laboratory Tests for the Diagnosis ofClinics in colon and rectal surgery · 2020Review
- A Multicenter Study of the Revogene C. difficile System for Detection of the Toxin B Gene from Unformed Stool Specimens.Journal of clinical microbiology · 2020Article
- Article
- Impact of the introduction of a nucleic acid amplification test forGut pathogens · 2018Article
- Clinical and economic impact of the introduction of a nucleic acid amplification assay for Clostridium difficile.Annals of clinical microbiology and antimicrobials · 2017Article
- Laboratory diagnosis of Clostridium difficile infection: Comparison of Techlab C. diff Quik Chek Complete, Xpert C. difficile, and multistep algorithmic approach.Journal of clinical laboratory analysis · 2017Article
19 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The incidence of Clostridium difficile infection (CDI) has risen almost 3-fold in the United States over the past decade, emphasizing the need for rapid and accurate tests for CDI. The Cepheid Xpert C. difficile assay is an integrated, closed, nucleic acid amplification system that automates sample preparation and real-time PCR detection of the toxin B gene (tcdB). A total of 432 stool specimens from symptomatic patients were tested by a glutamate dehydrogenase (GDH) assay, a toxin A and B enzyme immunoassay (EIA), the Xpert C. difficile assay, and a cell culture cytotoxicity neutralization assay (CCCN). The results of these methods, used individually and in combination, were compared to those of toxigenic culture. Results for the Xpert C. difficile assay alone showed a sensitivity, specificity, positive predictive value, and negative predictive value (NPV) of 94.4, 96.3, 84.0, and 98.8%, while the EIA alone gave corresponding values of 58.3, 94.7, 68.9, and 91.9%, respectively. An algorithm using the GDH assay and the EIA (plus the CCCN if the EIA was negative) showed corresponding values of 83.1, 96.7, 83.1, and 96.1%. The Xpert C. difficile assay was statistically superior to the EIA (P, <0.001 by Fisher's exact test) and to the GDH-EIA-CCCN algorithm (P, 0.0363). Combining the GDH and Xpert C. difficile assays lowered both the sensitivity and the NPV of the Xpert assay. The GDH-EIA-CCCN procedure required, on average, 2 days to complete testing on GDH-positive results, while testing by the Xpert C. difficile assay was completed, on average, in less than 1 h. Xpert C. difficile testing yielded the highest sensitivity and NPV, in the least amount of time, of the individual- and multiple-test algorithms evaluated in this study.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.