ArticleEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2015
Impact of clinical awareness and diagnostic tests on the underdiagnosis of Clostridium difficile infection.
Article in European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 3 of them syntheses that pooled it.
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Who cites it
21 citing papers in PubMed, 3 syntheses or guidelines pooled it, 62 citations in OpenAlex.
- Epidemiologic profile of community-acquiredEpidemiology and infection · 2025Pooled 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
- Pooled it
- Clinical impact of toxin detection in children with PCR-confirmed Clostridioides difficile infection.European journal of pediatrics · 2026Observational
- Pilot study ofEuro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2025Article
- Deep learning-based prediction of Clostridioides difficile infection caused by antibiotics using longitudinal electronic health records.NPJ digital medicine · 2024Article
- Use of PCR Cycle Threshold and Clinical Interventions to Aid in the Management of PediatricMicroorganisms · 2024Article
- Multidrug-Resistant Bacteria Contaminating Plumbing Components and Sanitary Installations of Hospital Restrooms.Microorganisms · 2024Review
- Effects of fermented soybean meal supplementation on the growth performance and apparent total tract digestibility by modulating the gut microbiome of weaned piglets.Scientific reports · 2023Article
- Complete genome sequence of theBioengineered · 2021Article
- A Rare Case of Pseudomembranous Colitis Presenting with Pleural Effusion and Ascites with Literature Review.Case reports in gastrointestinal medicine · 2021Article
- Saudi pharmaceutical journal : SPJ : the official publication of the Saudi Pharmaceutical Society · 2020Review
- Laboratory Diagnosis ofAnnals of laboratory medicine · 2019Article
- Cost-Effectiveness Analysis of Bezlotoxumab Added to Standard of Care Versus Standard of Care Alone for the Prevention of Recurrent Clostridium difficile Infection in High-Risk Patients in Spain.Advances in therapy · 2018Article
- Fecal Microbiota of ToxigenicFrontiers in microbiology · 2018Article
- Impact of the introduction of a nucleic acid amplification test forGut pathogens · 2018Article
- An outbreak of Clostridium difficile PCR ribotype 027 in Spain: risk factors for recurrence and a novel treatment strategy.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2017Observational
- Current knowledge on the laboratory diagnosis ofWorld journal of gastroenterology · 2017Review
- Prevalence and molecular epidemiology ofNew microbes and new infections · 2017Article
- Variability in testing policies and impact on reported Clostridium difficile infection rates: results from the pilot Longitudinal European Clostridium difficile Infection Diagnosis surveillance study (LuCID).European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2016Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
A multicenter study of Clostridium difficile infection (CDI) performed during 2008 in Spain revealed that two of every three episodes went undiagnosed or were misdiagnosed owing to nonsensitive diagnostic tests or lack of clinical suspicion and request. Since then, efforts have been made to improve the diagnostic tests used by laboratories and to increase the awareness of this disease among both clinicians and microbiologists. Our objective was to evaluate the impact of these efforts by assessing the current magnitude of underdiagnosis of CDI in Spain using two point-prevalence studies performed on one day each in January and July of 2013. A total of 111 Spanish laboratories selected all unformed stool specimens received for microbiological diagnosis on these days, and toxigenic culture was performed at a central reference laboratory. Toxigenic isolates were characterized both pheno- and genotypically. The reference laboratory detected 103 episodes of CDI in patients aged 2 years or more. Half (50.5 %) of the episodes were not diagnosed in the participating laboratories, owing to insensitive diagnostic tests (15.5 %) or the lack of clinical suspicion and request (35.0 %). The main ribotypes were 014, 078/126, 001/072, and 106. Ribotype 027 caused 2.9 % of all cases. Despite all the interventions undertaken, CDI remains a highly neglected disease because of the lack of sensitive diagnostic tests in some institutions and, especially, the absence of clinical suspicion, mainly in patients with community-associated CDI. Toxigenic C. difficile should be routinely sought in unformed stools sent for microbiological diagnosis, regardless of their origin.
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