Clostridioides difficile Infections in Children: What Is the Optimal Laboratory Diagnostic Method?
Abstract
:1. Introduction
2. Materials and Methods
2.1. Specimen Collection and Study Design
2.2. C. difficile Laboratory Diagnostic Tests
2.3. Statistical Analysis
3. Results
3.1. Samples and Demographics
3.2. Performance Characteristics Analysis
4. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Method | TAT | Ease of Use | Cost |
---|---|---|---|
GDH | 30 min | Simple, manual procedure | 11–20 USD |
Toxin | 30 min | Simple, manual procedure | 11–20 USD |
XCD | 60 min | Simple, automated procedure | 21–100 USD |
QGP | 75 min | Simple, automated procedure | >100 USD |
CAC | 24 h | Simple, manual procedure | <10 USD |
Algorithm 1 | 90 min | Simple, manual, and automated procedure | 21–100 USD |
Algorithm 2 | 105 min | Simple, manual, and automated procedure | >100 USD |
Algorithm 3 | 90 min | Simple, manual, and automated procedure | 21–100 USD |
Algorithm 4 | 105 min | Simple, manual, and automated procedure | >100 USD |
Method | Reference | TP | TN | FP | FN | Sensitivity (%) | Specificity (%) | PPV (%) | NPV (%) |
---|---|---|---|---|---|---|---|---|---|
GDH | Composite | 14 | 267 | 38 | 0 | 100 (78.5–100) | 87.5 (83.3–90.8) | 26.9 (16.8–40.3) | 100 (98.6–100) |
Toxin | Composite | 9 | 304 | 1 | 5 | 64.3 (38.8–83.7) | 99.7 (98.2–100) | 90 (59.6–98.2) | 98.4 (96.3–99.3) |
XCD | Composite | 14 | 273 | 32 | 0 | 100 (78.5–100) | 89.5 (85.6–92.5) | 30.4 (19–44.8) | 100 (98.6–100) |
QGP | Composite | 14 | 275 | 30 | 0 | 100 (78.5–100) | 90.2 (86.3–93) | 31.8 (20–45.6) | 100 (98.6–100) |
CAC | Composite | 13 | 266 | 39 | 1 | 92.9 (68.5–98.7) | 87.2 (83–90.5) | 25 (15.2–38.2) | 99.6 (97.9–99.9) |
Algorithm 1 | Composite | 16 | 289 | 14 | 0 | 100 (80.6–100) | 95.4 (92.4–97.2) | 53.3 (36.1–69.8) | 100 (98.7–100) |
Algorithm 2 | Composite | 14 | 290 | 15 | 0 | 100 (78.5–100) | 95.1 (92.1–97) | 48.3 (31.4–65.6) | 100 (98.7–100) |
Algorithm 3 | Composite | 8 | 305 | 0 | 6 | 57.1 (32.6–78.6) | 100 (98.8–100) | 100 (67.6–100) | 98.1 (95.9–99.1) |
Algorithm 4 | Composite | 8 | 305 | 0 | 6 | 57.1 (32.6–78.6) | 100 (98.8–100) | 100 (67.6–100) | 98.1 (95.9–99.1) |
Method | Reference | TP | TN | FP | FN | Sensitivity (%) | Specificity (%) | PPV (%) | NPV (%) |
---|---|---|---|---|---|---|---|---|---|
GDH | Composite | 2 | 40 | 13 | 0 | 100 (34.2–100) | 75.5 (62.4–85.1) | 13.3 (3.7–37.9) | 100 (91.2–100) |
Toxin | Composite | 1 | 53 | 0 | 1 | 50 (9.5–90.6) | 100 (93.2–100) | 100 (20.7–100) | 98.2 (90.2–99.7) |
XCD | Composite | 2 | 41 | 12 | 0 | 100 (34.2–100) | 77.4 (64.5–86.6) | 14.3 (4–39.9) | 100 (91.4–100) |
QGP | Composite | 2 | 41 | 12 | 0 | 100 (34.2–100) | 77.4 (64.5–86.6) | 14.3 (4–39.9) | 100 (91.4–100) |
CAC | Composite | 2 | 42 | 11 | 0 | 100 (34.2–100) | 79.3 (66.5–88) | 15.4 (4.3–42.2) | 100 (91.4–100) |
Algorithm 1 | Composite | 0 | 45 | 10 | 0 | NA | 81.8 (69.7–89.8) | NA | 100 (92.1–100) |
Algorithm 2 | Composite | 2 | 45 | 8 | 0 | 100 (34.2–100) | 84.9 (73–92.1) | 20 (5.7–51) | 100 (92.1–100) |
Algorithm 3 | Composite | 1 | 53 | 0 | 1 | 50 (9.5–90.6) | 100 (93.2–100) | 100 (20.7–100) | 98.2 (90.2–99.7) |
Algorithm 4 | Composite | 1 | 53 | 0 | 1 | 50 (9.5–90.6) | 100 (93.2–100) | 100 (20.7–100) | 98.2 (90.2–99.7) |
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Suleiman, M.; Tang, P.; Imam, O.; Morales, P.; Altrmanini, D.; Roberts, J.C.; Pérez-López, A. Clostridioides difficile Infections in Children: What Is the Optimal Laboratory Diagnostic Method? Microorganisms 2024, 12, 1785. https://doi.org/10.3390/microorganisms12091785
Suleiman M, Tang P, Imam O, Morales P, Altrmanini D, Roberts JC, Pérez-López A. Clostridioides difficile Infections in Children: What Is the Optimal Laboratory Diagnostic Method? Microorganisms. 2024; 12(9):1785. https://doi.org/10.3390/microorganisms12091785
Chicago/Turabian StyleSuleiman, Mohammed, Patrick Tang, Omar Imam, Princess Morales, Diyna Altrmanini, Jill C. Roberts, and Andrés Pérez-López. 2024. "Clostridioides difficile Infections in Children: What Is the Optimal Laboratory Diagnostic Method?" Microorganisms 12, no. 9: 1785. https://doi.org/10.3390/microorganisms12091785