Category Archives: C. diff. Lab Testing

Clostridioides difficile Infection (CDI) In Patients With Inflammatory Bowel Disease (IBD)









Clostridioides difficile Infection (CDI) In Patients with Inflammatory Bowel Disease – What’s New

Our guest James Boone, M.S., discusses Inflammatory Bowel Disease patients who are highly susceptible to C. difficile infections. The two diseases have similar symptoms, but very different treatments. This episode will examine the diagnostic methods which can distinguish between inflammatory bowel disease and a C. difficile infection, discuss testing guidelines, and touch upon recent clinical research and advances.

Research Article:

Low glutamate dehydrogenase levels are associated with colonization in Clostridium difficile PCR-only positive patients with inflammatory bowel disease

Low glutamate dehydrogenase levels are associated…

Researchers Evaluate Healthcare-Onset and Healthcare-Facility-Associated C. difficile Infections


Dipesh Solanky12Derek K Juang#12Scott T Johns#3Ian C Drobish12Sanjay R Mehta124Monika Kumaraswamy1245


Objective: Lack of judicious testing can result in the incorrect diagnosis of Clostridioides difficile infection (CDI), unnecessary CDI treatment, increased costs, and falsely augmented hospital-acquired infection (HAI) rates. We evaluated facility-wide interventions used at the VA San Diego Healthcare System (VASDHS) to reduce healthcare-onset, healthcare-facility-associated CDI (HO-HCFA CDI), including the use of diagnostic stewardship with test ordering criteria.

Design: We conducted a retrospective study to assess the effectiveness of measures implemented to reduce the rate of HO-HCFA CDI at the VASDHS from fiscal year (FY)2015 to FY2018.

Interventions: Measures executed in a stepwise fashion included a hand hygiene initiative, prompt isolation of CDI patients, enhanced terminal room cleaning, reduction of fluoroquinolone and proton-pump inhibitor use, laboratory rejection of solid stool samples, and lastly diagnostic stewardship with C. difficile toxin B gene nucleic acid amplification testing (NAAT) criteria instituted in FY2018.

Results: From FY2015 to FY2018, 127 cases of HO-HCFA CDI were identified. All rate-reducing initiatives resulted in decreased HO-HCFA cases (from 44 to 13; P ≤ .05). However, the number of HO-HCFA cases (34 to 13; P ≤ .05), potential false-positive testing associated with colonization and laxative use (from 11 to 4), hospital days (from 596 to 332), CDI-related hospitalization costs (from $2,780,681 to $1,534,190) and treatment cost (from $7,158 vs $1,476) decreased substantially following the introduction of diagnostic stewardship with test criteria from FY2017 to FY2018.

Conclusions: Initiatives to decrease the risk for CDI and diagnostic stewardship of C. difficile stool NAAT significantly reduced HO-HCFA CDI rates, detection of potential false-positives associated with laxative use, and lowered healthcare costs. Diagnostic stewardship itself had the most dramatic impact on outcomes observed and served as an effective tool in reducing HO-HCFA CDI rates.





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Researchers Combined Efforts Will Hopefully Lead To Improved Recognition Of Clostridioides difficile Pathogen To Reduce the Suffering and Economic Losses Caused by a CDI

Clostridioides difficile Infection: The Challenge, Tests, and Guidelines



Clostridioides difficile is a dangerous human pathogen because it can grow to high numbers in the intestine, cause colitis with its potent toxins, and persist as spores. C. difficile infection (CDI) is the primary hospital-acquired infection in North America and Europe, and it now is a global disease. Even with newer laboratory tests, there still is confusion on accurately diagnosing this disease. Three guidelines from three different healthcare-affiliated societies have recently been published. Consensus consolidated recommendations from these guidelines should be recognized by healthcare professionals, who need to understand why this disease continues to be difficult to diagnose and need a clear understanding of the advantages and limitations of current tests. Hopefully, these combined efforts will lead to an improvement in the recognition of this pathogen and a reduction in the suffering and economic loss caused by CDI.




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Frost & Sullivan Recognizes First Light Diagnostics, Inc. With the 2019 North American Technology Innovation Award for its Patented MultiPath Platform and Diagnostics Tests

Based on its recent analysis of the North American rapid diagnostics market, Frost & Sullivan recognizes First Light Diagnostics, Inc. with the 2019 North American Technology Innovation Award for its patented MultiPath platform and diagnostics tests for the infectious disease market. The platform enables pathogen identification in 30 minutes and antimicrobial susceptibility testing (AST) results in four hours directly from the patient sample, thereby expediting treatment decisions by one to two days.

“The MultiPath platform’s direct-from-specimen testing eliminates the need for an intermediate culture step, while the ultra-sensitive detection feature identifies the low number of cells that might be present in uncultured patient samples,” said Bhargav Rajan, Leader, Medical Devices & Imaging Team at Frost & Sullivan. “The platform is a fully automated sample-to-result solution and can perform up to 20 ASTs simultaneously, which dramatically improves throughput and workflow. The platform is unaffected by samples containing multiple species of pathogens that contaminate microbes and sample matrices.”

First Light provides a cost-effective and specific test for

diagnosing Clostridium difficile (C. difficile) infection. By being both highly sensitive and specific, this test stands out from insensitive enzyme immunoassays and non-specific nucleic acid amplification tests.

The test is up to 60 times more sensitive than other available tests and detects the toxin at levels that clinically qualifies it as an infection. First Light’s test has higher specificity than nucleic acid amplification tests, because it only detects disease-causing toxins that are generated by the growing bacteria but not dormant spores found in colonized patients, which is one of the platform’s strongest selling points.

First Light’s MultiPath platform addresses the challenge with healthcare-acquired infections (HAIs) as well. For example, the platform aids rapid, high-throughput, and cost-effective patient screening tests for a wide variety of superbugs and is not confounded by the multiple genes and mutations that cause antibiotic resistance.

The tests identify resistance phenotypically by determining whether the antibiotic stops the cells from growing. This approach works well even if the genetics of the resistance mechanisms are complex. Future applications include tests for the major types of serious infections such as pneumonia, surgical site infections, urinary tract infections, and sepsis in addition to screening tests for superbugs, such as methicillin-resistant Staphylococcus aureus (MRSA).

“First Light’s technology can detect infections, toxins, biomarkers, and diagnostically informative human cells and identify pathogens in only 30 minutes, which is twice as fast as traditional methods,” noted Rajan. “Overall, First Light is expected to continue growing as its AST results are rapid and can be taken from different sample types; ultrasensitive tests for toxins and biomolecules are more accurate; and products offer high throughput and high performance at a low cost and small footprint.”

Each year, Frost & Sullivan presents this award to the company that has developed a product with innovative features and functionality that is gaining rapid acceptance in the market. The award recognizes the solution’s quality and the customer value enhancements it enables.

Frost & Sullivan Best Practices Awards recognize companies in a variety of regional and global markets for demonstrating outstanding achievement and superior performance in areas such as leadership, technological innovation, customer service, and strategic product development. Industry analysts compare market participants and measure performance through in-depth interviews, analyses, and extensive secondary research to identify best practices in the industry.

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Researchers at Chinese University of Hong Kong Develop Fluorescent Microrobots to Detect C.diff.

Researchers at Chinese University of Hong Kong (CUHK) have developed fluorescent microrobots that can spot C. diff in a stool sample within a matter of minutes without relying on expensive laboratory equipment.

The technology relies on fungi spore-inspired microrobots that feature fluorescent functionalised carbon nanodots. When the microrobots encounter toxins produced by C. diff, the brightness of the fluorescence changes, something that can be detected with digital photo equipment.

The process is accelerated by the shape and structure of the microrobots, which spread throughout a diluted stool sample and quickly come in contact with as much as the present toxins as possible. This “active” process also helps to detect low concentrations of toxins, according to the researchers.

Additionally, because the microrobots have iron-based nanoparticles in their structure, they can be manipulated by an external magnetic field and gathered together for best visualization.

Study in journal Science Advances: Real-time tracking of fluorescent magnetic spore–based microrobots for remote detection of C. diff toxins


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