Ontañón ZD, Gutiérrez LI, Rivas NJP, Fernández CE, Garciadiego FP, Hoyo UI

Language: Spanish
References: 14
Page: 100-104
PDF size: 232.24 Kb.

ABSTRACT

Background: Clostridium difficile is the most common cause of diarrhea in hospitalized patients. Definitive diagnosis is made by the demonstration of citotoxins in feces. The gold standard is the citotoxicity test of B toxin in cellular cultures; nevertheless, the most used test is the toxin A and B immunoassay. Objective: To analyze the degree of concordance for the diagnosis of infection by Clostridium difficile between two diagnostic tests: gastrointestinal Film Array^® and toxins A and B test. Material and methods: Retrospective transversal study that included patients of 18 years and older hospitalized between from March 2016 and July 2017 diagnosed with infection by Clostridium difficile and with both diagnostic tests: Gastrointestinal Film Array^® and toxins A and B test. Results: A total of 66 patients were included, the diagnosis of Clostridium difficile infection was made in 95% by Film Array^® of which only 33% had a positive A/B toxins test, concluding a percentage of discordant results of 68.2%. We found that treatment with proton bomb inhibitors (PBI) was an independent risk factor for the presence of these discordant results between the tests [OR = 4.8 (IC 95%, 1.4-16.49 p = 0.02)]. Conclusions: We found an important discordance between the two tests, this could be explained by the tendency to use them without suggestive manifestations or the existence of factors that cause the different results, like the use of PBI, patients in the intensive care unit and the presence of other infections.

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