Clostridium difficile is an increasingly important problem being faced by clinical microbiologists. From 1993 to 2009, incidence of C. difficile increased fourfold (85,700 cases increased to 336,600 cases) in the United States. Because of this, it has become a significant area of research, as researchers search for better antimicrobial therapies, diagnostic assays, and prevention tactics.
ASM recently invited Alice Guh, MD, MPH, of the Centers for Disease Control and Prevention, to present the most recent C. difficile research as part of the Hot Topics in Clinical Microbiology series*. In her presentation, ‘Update on Clostridium difficile Infection’, Guh first describes the changing epidemiology of C. difficile infections (CDI), updating the data from the CDC’s Emerging Infections Program (EIP) and their long-term surveillance of CDI within the United States.
Guh further reviews current CDI diagnostic testing and its associated challenges. She highlights the benefits and downfalls of traditional enzyme immunoassay to detect C. difficile toxins compared to the nucleic acid amplification tests (NAAT) first put to widespread use in 2009.
Finally, Guh describes the role of asymptomatic carriers in C. difficile transmission. Her review of the literature presents best practices to trace transmission from asymptomatic carriers as well as suggested strategies to stop this transmission.
*Hot Topics are presentations available as a benefit of ASM membership. Not a member? Signing up is quick and easy if you follow this link. If you are a trainee with a few friends who also wish to become members, joining together gives you a 20% discount if you follow this link.
The March 2017 Cover of Journal of Clinical Microbiology.
CDI diagnostics have also been covered frequently in the Journal of Clinical Microbiology, with a number of reports published in the first three months of 2017. One major area these studies have focused on is how best to predict who might develop disease symptoms due to CDI:
- Real-Time Electronic Tracting of Diarrheal Episodes and Laxative therapy Enables Verification of Clostridium difficile Clinical Testing Criteria and Reduction of Clostridium difficile Infection Rates.
- Evaluation of Correlation between Pretest Probability for Clostridium difficile infection and Clostridium difficile Enzyme Immunoassay Results.
Another major area of focus is the assays used for detection, and which might be most effective:
- Evaluation of the New FecalSwabTM to Maintain Stability of Stool Samples Submitted for Molecular Tests.