The problem, the consequences, and rapid testing solutions
Healthcare Associated Infections (HAIs) are a global concern causing significant mortality and morbidity as well as spiralling healthcare costs worldwide.
Clostridium difficile is the most common cause of Healthcare Associated Diarrhea in industrialized countries.1 In North America, C. difficile is present in 13 of every 1,000 hospital inpatients2 and the estimated annual economic burden is approximately $3.2 billion.3
It is commonly associated with prior exposure to broad-spectrum antibiotics that compromise a patient's normal gut flora, allowing C. difficile to proliferate and cause toxin-mediated disease. This can proceed to serious, life-threatening conditions such as Pseudomembranous Colitis (PMC).
(CDI) is a consequence of antibiotic use, which is exacerbated by inappropriate and widespread use of broad-spectrum agents. Any steps which can be implemented to effectively target narrow-spectrum antibiotic therapy would have a positive impact on the down-stream incidence of (CDI) as well as a substantial reduction of associated healthcare costs.
In addition, diagnostics for (CDI) are challenging. In recent times, traditional toxin A/B EIA tests have been identified as sub-optimal in performance and not recommended as single-line tests by various national guidelines.1,4,5,6,7
More recently, molecular-based tests have become commercially available but the latest data suggests these tests are not specific enough to be used as single-line tests.8 There are real concerns that these tests may overdiagnose (CDI), resulting in inappropriate antimicrobial therapy and an increased likelihood of a more severe re-infection.
Your patient has a recent history of antibiotic treatment and symptoms of Clostridium difficile Infection (CDI). Which diagnostic pathway do you choose for your patient?
The latest guidelines recommend an algorithmic testing approach where Glutamate Dehydrogenase (GDH) tests or molecular technology are used to screen patients and a sensitive Toxin A/B test is used to confirm disease.8
The unique C. DIFF QUIK CHEK COMPLETE® test from Alere (developed and manufactured by TECHLAB, Inc.) detects GDH and Toxin A/B simultaneously in less than 30 minutes. This test has been shown by multiple peer-reviewed studies from N. America, Europe and Asia to be an extremely effective tool to detect (CDI).8,9,10,11,12,13,14
- Crobach, et al. Clin Micro and Infect 2009
- Association for Professionals in Infection Control and Epidemiology (APIC). National Prevalence Study of C. difficile in U.S. Heathcare Facilities. 2008
- O’Brien et al. Infect Control Hosp Epidemiol 2007
- Delmee, et al. J Med Micro 2005
- Planche, et al. Lancet Infect Dis 2008
- Eastwood, et al. J Clin Micro 2009
- Cohen, et al. Infect Control Hosp Epidemiol 2010
- U.K. Department of Health. Updated guidance on the diagnosis and reporting of C. difficile. 2012
- Swindells, et al. J Clin Micro 2010
- Kawada, et al. J Infect Chemother 2010
- Bruins, et al. Eur J Clin Microbiol Infect Dis 2012
- Orellana-Miguel, et al. Enferm Infecc Microbiol Clin 2012
- Yi-Chieh Lee, et al. J Microbiol, Immuno and Infect 2012
- Culbreath, et al. J Clin Micro 2012
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