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Diagnosing Clostridium difficile-associated diarrhea using enzyme immunoassay: the clinical significance of toxin negativity in glutamate dehydrogenase-positive patients

Overview of attention for article published in Infection and Drug Resistance, May 2016
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Title
Diagnosing Clostridium difficile-associated diarrhea using enzyme immunoassay: the clinical significance of toxin negativity in glutamate dehydrogenase-positive patients
Published in
Infection and Drug Resistance, May 2016
DOI 10.2147/idr.s105429
Pubmed ID
Authors

Kazuhito Yuhashi, Yuka Yagihara, Yoshiki Misawa, Tomoaki Sato, Ryoichi Saito, Shu Okugawa, Kyoji Moriya

Abstract

The enzyme immunoassay (EIA) has lower sensitivity for Clostridium difficile toxins A and B than the polymerase chain reaction in the diagnosis of C. difficile-associated diarrhea (CDAD). Furthermore, toxin positivity with EIA performed on C. difficile isolates from stool cultures may be observed even in patients with EIA glutamate dehydrogenase (GDH)-positive and toxin-negative stool specimens. It is unclear whether such patients should be treated as having CDAD. The present study retrospectively compared patient characteristics, treatment, and diarrhea duration among three groups of patients who underwent stool EIA testing for CDAD diagnosis: a toxin-positive stool group (positive stool group; n=39); a toxin-negative stool/toxin-positive isolate group (discrepant negative/positive group, n=14); and a dual toxin-negative stool and isolate group (dual negative group, n=15). All cases included were confirmed to be GDH positive on EIA test. Patients' backgrounds and comorbidities were not significantly different among three groups. No difference was observed among the three groups with regard to antimicrobial drug use before diarrhea onset. Treatment was received by 82.1% of the positive stool group compared to 7.1% of the discrepant positive/negative group and 0% of the dual negative group, while mean diarrhea duration was 10.6 days compared to 7.9 days (P=0.6006) and 3.4 days (P=0.0312), respectively. Even without treatment, patients with toxin-negative stool specimens had shorter diarrhea duration than those with toxin-positive stool specimens even with toxin-positive isolates. These findings may suggest a limited need for CDAD treatment for GDH-positive patients and toxin-negative stool specimens.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 22 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 22 100%

Demographic breakdown

Readers by professional status Count As %
Other 4 18%
Researcher 4 18%
Student > Postgraduate 2 9%
Student > Ph. D. Student 2 9%
Lecturer 1 5%
Other 3 14%
Unknown 6 27%
Readers by discipline Count As %
Biochemistry, Genetics and Molecular Biology 4 18%
Immunology and Microbiology 4 18%
Environmental Science 2 9%
Medicine and Dentistry 2 9%
Linguistics 1 5%
Other 3 14%
Unknown 6 27%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 20 June 2016.
All research outputs
#20,333,181
of 22,877,793 outputs
Outputs from Infection and Drug Resistance
#1,264
of 1,659 outputs
Outputs of similar age
#252,812
of 298,395 outputs
Outputs of similar age from Infection and Drug Resistance
#8
of 9 outputs
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