ArticleJournal of clinical microbiology2011
Rapid stool-based diagnosis of Clostridium difficile infection by real-time PCR in a children's hospital.
Article in Journal of clinical microbiology, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers.
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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.
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Who cites it
34 citing papers in PubMed, 76 citations in OpenAlex.
- Noroviruses as a Cause of Diarrhea in Immunocompromised Pediatric Hematopoietic Stem Cell and Solid Organ Transplant Recipients.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2015Trial
- Observational
- Trends and Disparities inGastroenterology research and practice · 2026Article
- Co-infection and interaction of enteric pathogens in acute diarrhea among children under five years: a large-scale multicenter observational study from China.Infectious diseases of poverty · 2025Observational
- Article
- Review
- Clostridium difficile infection in pediatric patients (Review).Biomedical reports · 2024Review
- Advances in diagnostic assays forFrontiers in cellular and infection microbiology · 2024Review
- Comparison of toxin gene expression levels and molecular typing ofGastroenterology and hepatology from bed to bench · 2024Article
- Clostridioides difficile Infection in Children: Recent Updates on Epidemiology, Diagnosis, Therapy.Pediatrics · 2023Review
- Clostridioides difficile infection in infants: a case report and literature review.Gut pathogens · 2023Article
- A rapid multiplex real-time PCR detection of toxigenic3 Biotech · 2023Article
- Trends and Disparities in Outcomes ofJournal of clinical medicine research · 2022Article
- Development of a Rapid and Fully Automated Multiplex Real-Time PCR Assay for Identification and Differentiation ofFrontiers in cellular and infection microbiology · 2021Article
- Multi-omic Analysis of the Interaction between Clostridioides difficile Infection and Pediatric Inflammatory Bowel Disease.Cell host & microbe · 2020Article
- Cost-effectiveness of integrating gut microbiota analysis into hospitalisation prediction in cirrhosis.GastroHep · 2020Article
- Outcomes and clinical relevance of stool multiplex bacterial polymerase chain reaction in patients with acute diarrhea: single center experience.The Korean journal of internal medicine · 2020Article
- Effectiveness of a Two-Step Testing Algorithm for Reliable and Cost-Effective Detection of Clostridium difficile Infection in a Tertiary Care Hospital in Saudi Arabia.Medical sciences (Basel, Switzerland) · 2019Article
- Role of interferon-γ and inflammatory monocytes in driving colonic inflammation during acute Clostridium difficile infection in mice.Immunology · 2017Article
- Recurrent Clostridium difficile Infection in Children: Patient Risk Factors and Markers of Intestinal Inflammation.The Pediatric infectious disease journal · 2017Observational
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Clostridium difficile is a major cause of nosocomial antibiotic-associated infectious diarrhea and pseudomembranous colitis. Detection of C. difficile by anaerobic bacterial culture and/or cytotoxicity assays has been largely replaced by rapid enzyme immunoassays (EIA). However, due to the lack of sensitivity of stool EIA, we developed a multiplex real-time PCR assay targeting the C. difficile toxin genes tcdA and tcdB. Stool samples from hospitalized pediatric patients suspected of having C. difficile-associated disease were prospectively cultured on cycloserine-cefoxitin-fructose agar following alcohol shock. Six testing modalities were evaluated, including stool EIA, culture EIA, and real-time PCR (tcdA and tcdB) of cultured isolates and stool samples. Real-time PCR detection was performed with tcdA and tcdB gene-specific primers and hydrolysis probes using the LightCycler platforms (Roche Diagnostics, Indianapolis, IN). A total of 157 samples from 96 pediatric patients were analyzed. The sensitivities of stool real-time PCR and stool EIA were 95% and 35%, respectively, with a specificity of 100% for both methods. The lower limit of detection of the stool real-time PCR was 30 CFU/ml of stool sample per reaction for tcdA and tcdB. This study highlights the poor performance of stool toxin EIAs in pediatric settings. Direct detection of C. difficile toxin genes in stool samples by real-time PCR showed sensitivity superior to that of stool and culture EIAs and performance comparable to that of real-time PCR assay of cultured isolates. Real-time PCR of DNA from stool samples is a rapid and cost-effective diagnostic modality for children that should facilitate appropriate patient management and halt the practice of serial testing by EIA.
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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.