Earn continuing education credits in this review of screening, the NAP1 marker, and more
A new continuing education article in Medical Laboratory Observer offers a look at improved approaches to testing for Clostridium difficile. The piece comes from our own Sherry Dunbar, Senior Director of Global Scientific Affairs, and can be used to earn continuing education units (CEUs).
Clinical Guidelines
The article delves into new clinical guidelines issued by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America for C. difficile testing, treatment, and prevention. In addition to significant changes in treatment recommendations, the new guidelines also address molecular diagnostics. “According to the latest protocols, testing should be restricted to patients who have at least three bouts of diarrhea in a 24-hour period, and within these cases, testing is only recommended when diarrhea has started recently and cannot otherwise be explained,” Dunbar reports. The guidelines also advise that patients who receive negative C. diff test results should not be retested within a week, and babies younger than 12 months should not be tested at all.
Relevant Studies
The MLO article also covers recent studies relevant to C. diff testing and treatment, with several studies focusing on the different ribotypes of the pathogen. While much emphasis has been placed on testing for the BI/NAP1/027 ribotype, shifting patterns of ribotype distribution suggest that this may not be the best course. “Given these patterns, it seems unwise to focus C. difficile testing on the identification of NAP1, which is often used today as an indicator of disease severity,” Dunbar writes. “Patient history and symptoms should be used with the standard guidelines to ensure optimal treatment for each patient, regardless of the presence or absence of the NAP1 marker.”
Other studies included look at the utility of broader C. diff screening policies. In two major studies, hospitals that screened patients to determine their C. diff colonization status and then isolated patients with positive results had lower rates of hospital-associated C. diff infections. “Asymptomatic patients represent a reservoir of C. difficile, and there are benefits to identifying them in hospital settings so they can be kept away from non-colonized patients who are at risk of acquiring the pathogen and suffering an infection from it,” Dunbar notes.
She adds that clinical labs have a key role to play in reducing C. diff transmission and improving patient outcomes. “By ensuring optimal testing protocols and considering screening policies for all patients admitted to hospitals, laboratorians stand to make a real impact in the C. difficile infection arena,” Dunbar concludes.
Related Content
- Webinar: Labs Switch from Stool Cultures to Molecular Testing for GI Cases [Webinar]
- Colorado Lab Uses VERIGENE EP Test to Rapidly Identify Shiga Toxin [Blog]
- Choosing an MDx Platform [Blog]
- From the Trenches: Expert Guidance for Molecular GI Testing [Blog]
- Luminex Gastrointestinal Infections Portfolio [Web Page]
