PCR Detection of C. diff Less Accurate Than Assay, Toxigenic Culture

Up to 72 percent of healthcare-associated diarrhea may not be attributable to Clostridium difficile-associated disease, according to a study in Infection Control and Hospital Epidemiology.

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Researchers tested the accuracy of real-time polymerase chain reaction for detecting CDAD after infection rates at the hospital increased following PCR usage for detection.

Researchers screened patients for C. diff using real-time PCR, a toxin enzyme-linked immunosorbent assay and a toxigenic culture.

C. diff was detected in 18 percent of the participants using real-time PCR detection. Of the patients with detected C. diff, 72 percent had asymptomatic C. diff colonization.

Researchers suggest PCR detection may be contributing to the rising rates of CDAD by reporting false positives, as asymptomatic C. diff colonization is overrepresented in actual CDAD rates. They also suggest further studies are needed to develop a standard in CDAD diagnostic testing and to guide PCR detection interpretation.

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