Evidence map›Paper›PMID 26377204›Full record

ArticleEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2015

Diagnostic yield of repeat sampling with immunoassay, real-time PCR, and toxigenic culture for the detection of toxigenic Clostridium difficile in an epidemic and a non-epidemic setting.

J van Prehn, C M J E Vandenbroucke-Grauls, Y H van Beurden, R van Houdt, S Vainio, C W Ang

Open access · hybridAbstract readEvaluation Study
PubMed Full text at PMC Publisher
In one paragraph

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 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
1.4field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 19 citations in OpenAlex.

  1. Diagnostic Guidance for C. difficile Infections.Advances in experimental medicine and biology · 2024
    Article
  2. Article
  3. Pediatric gastroenterology, hepatology & nutrition · 2022
    Article
  4. Implementing a Clostridium difficile testing algorithm and its effect on isolation duration and treatment initiation: a pre- and post-implementation study.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2020
    Article
  5. Article
  6. The Role of Diagnostic Stewardship inCurrent infectious disease reports · 2020
    Article
  7. [Gastrointestinal infections].Der Internist · 2017
    Review
  8. IDCases · 2017
    Article
  9. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

J van PrehnDepartment of Medical Microbiology and Infection Control PK 1 X 124, VU University Medical Center, De Boelelaan 1118, 1081 HV, Amsterdam, The Netherlands. j.vanprehn@vumc.nl.
C M J E Vandenbroucke-GraulsDepartment of Medical Microbiology and Infection Control PK 1 X 124, VU University Medical Center, De Boelelaan 1118, 1081 HV, Amsterdam, The Netherlands.
Y H van BeurdenDepartment of Medical Microbiology and Infection Control PK 1 X 124, VU University Medical Center, De Boelelaan 1118, 1081 HV, Amsterdam, The Netherlands.
R van HoudtDepartment of Medical Microbiology and Infection Control PK 1 X 124, VU University Medical Center, De Boelelaan 1118, 1081 HV, Amsterdam, The Netherlands.
S VainioDepartment of Medical Microbiology and Infection Control PK 1 X 124, VU University Medical Center, De Boelelaan 1118, 1081 HV, Amsterdam, The Netherlands.
C W AngDepartment of Medical Microbiology and Infection Control PK 1 X 124, VU University Medical Center, De Boelelaan 1118, 1081 HV, Amsterdam, The Netherlands.
Amsterdam UMC Location VUmc · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Current international guidelines lack definite conclusions regarding repeat stool sampling for the detection of toxigenic Clostridium difficile. We assessed the value of repeat sampling and compared the diagnostic yield in an epidemic to a non-epidemic setting. Consecutive fecal samples obtained during two time frames were analyzed using direct stool immunoassay toxin testing (enzyme immunoassay [EIA]), direct stool real-time PCR toxin gene testing, and toxigenic culture. Samples collected within 7 days of the initial sample were considered repeat tests. In the epidemic setting 989 patients were analyzed, and in the non-epidemic setting 1,015. In the epidemic setting 204 patients had two or more specimens included for analysis and in the non-epidemic setting 287 patients. In the epidemic setting 136 samples yielded a positive results, either by EIA or toxigenic culture; of these, 108 were positive according to EIA and 123 according to toxigenic culture. In the first test round 98 (90.7%, 95% CI 85.3 to 96.2), 114 (92.7%, 88.1 to 97.3), and 126 (92.6%, 88.3 to 97.0) positives were detected. Subsequent test rounds yielded 10 (9.3%, 3.8 to 14.7), 9 (7.3%, 2.7 to 11.9), and 10 (7.4%, 3.0 to 11.7) extra positives. In the non-epidemic setting EIA, toxigenic culture and PCR detected 33, 66, and 83 positives. The three tests combined 93 detected positives. In the first test round 30 (90.9%, 81.1 to 100.7), 63 (95.5%, 90.4 to 110.5), 76 (91.6%, 85.6 to 97.5), and 87 (93.5%, 88.6 to 98.5) positives were detected. Subsequent test rounds yielded 3 (9.1%, -0.7 to 18.9), 3 (4.5%, -0.5 to 9.6), 7 (8.4%, 2.5 to 14.4), and 6 (6.5%, 1.5 to 11.4) extra positives. In conclusion, repeat testing resulted in 4.5% to 9.3% extra positives. No significant difference between the settings studied could be demonstrated. Repeat sampling and multimodality testing may be chosen in an outbreak situation to detect all cases, effectively controlling nosocomial spread.

Indexed as

Cell Culture TechniquesClostridioides difficileClostridium InfectionsDiarrheaFecesHumansImmunoassayProspective StudiesReal-Time Polymerase Chain ReactionRetrospective StudiesSpecimen Handling

Identifiers

PMID26377204
PMCPMC4655006
OpenAlexW1951182209

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.