ArticleAnnals of clinical microbiology and antimicrobials2024
Clinical outcomes and treatment necessity in patients with toxin-negative Clostridioides difficile stool samples.
Article in Annals of clinical microbiology and antimicrobials, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 3 citations in OpenAlex.
- Clinical predictors of enzyme immunoassay accuracy in Clostridioides difficile infection: the impact of immune status and infection predisposing factors.BMC infectious diseases · 2026Article
- Clinical features of NAAT-positive, toxin-negative Clostridioides difficile infections in South Korea.The Korean journal of internal medicine · 2026Article
- Implementation of two-stage testing forAntimicrobial stewardship & healthcare epidemiology : ASHE · 2026Article
- Challenges and Strategies in Managing RecurrentGeriatrics (Basel, Switzerland) · 2025Article
- Three stages of laboratory stewardship in improving appropriateAntimicrobial stewardship & healthcare epidemiology : ASHE · 2025Article
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Authors and funding
12 authors at 3 institutions in 1 country.
Funding
Abstract
purposeThe clinical significance of negative toxin enzyme immunoassays (EIA) for Clostridioides difficile infections (CDIs) is unclear. Our study aimed to investigate the significance of toxin EIA-negative in the diagnosis and prognosis of CDI.
methodsAll stool specimens submitted for C. difficile toxin EIA testing were cultured to isolate C. difficile. In-house PCR for tcdA, tcdB, cdtA, and cdtB genes were performed using C. difficile isolates. Stool specimens were tested with C. difficile toxins A and B using EIA kit (RIDASCREEN Clostridium difficile toxin A/B, R-Biopharm AG, Darmstadt, Germany). Characteristics and subsequent CDI episodes of toxin EIA-negative and -positive patients were compared.
resultsAmong 190 C. difficile PCR-positive patients, 83 (43.7%) were toxin EIA-negative. Multivariate analysis revealed independent associations toxin EIA-negative results and shorter hospital stays (OR = 0.98, 95% CI 0.96-0.99, p = 0.013) and less high-risk antibiotic exposure in the preceding month (OR = 0.38, 95% CI 0.16-0.94, p = 0.035). Toxin EIA-negative patients displayed a significantly lower white blood cell count rate (11.0 vs. 35.4%, p < 0.001). Among the 54 patients who were toxin EIA-negative and did not receive CDI treatment, three (5.6%) were diagnosed with CDI after 7-21 days without complication.
conclusionOur study demonstrates that toxin EIA-negative patients had milder laboratory findings and no complications, despite not receiving treatment. Prolonged hospitalisation and exposure to high-risk antibiotics could potentially serve as markers for the development of toxin EIA-positive CDI.
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