DON'T MISS BIOMÉRIEUX SOLUTIONS FOR C.difficile DETECTION
C.difficile AWARENESS MONTH
DON’T MISS A DIAGNOSIS WITH BIOMÉRIEUX SOLUTIONS
FOR C.difficile DETECTION
Clostridioides difficile (C. difficile) is one of the most challenging Healthcare Associated Infections (HAI)1. C. difficile is usually acquired in the healthcare setting and is associated to antibiotic treatment. C. difficile infection (CDI) generates costly treatment, patient isolation and longer hospital stays2.
The rise of Community Acquired Infections is of concern and now accounts for 35-48% of CDI diagnosis in the US2. During a point-prevalence study in Europe, the CDI positivity was found to be at 1.3% in community samples, and half of community CDI cases were undetected because of absence of clinical suspicion, representing 3 times more undiagnosed adults in the community compared with hospitals3.
Continued appropriate infection control, antibiotic use, and diagnostic testing are important in decreasing C. difficile cases3.
Based on the ACG, IDSA and ESCMID guidelines, the diagnosis of CDI should include a two-step approach with both a highly sensitive and a highly specific testing methods to help distinguish colonization from active infection3,5,6. At bioMérieux we have methods to help you diagnose C. difficile in routine stool testing.
In the case of C. difficile in the community, the BIOFIRE® FILMARRAY® Gastrointestinal (GI) Panel is the solution of choice because of its high sensitivity and thanks to its broad menu, helping to detect unsuspected pathogens7.
In the context of hospital acquired C. difficile infection, the choice between BIOFIRE GI Panel and VIDAS® GDH should be made based on the clinical picture of each patient.
C.difficile
in the
COMMUNITY
Sensitive Method
BIOFIRE® Gastrointestinal (GI) Panel
Specific Method
VIDAS® CDAB**
C.difficile
as an
HAI
Sensitive Method
BIOFIRE® Gastrointestinal (GI) Panel
or
VIDAS® GDH*
Specific Method
VIDAS® CDAB**
Outbreak management
CHROMID® C.difficile,
BIOFIRE® Syndromic Trends,
EPISEQ®
* VIDAS® C. difficile GDH
** VIDAS® C. difficile Toxin A & B
bioMérieux offers a comprehensive solution for all the steps of the CDI diagnosis and management.
BIOFIRE® FILMARRAY® Gastrointestinal (GI) Panel
The BIOFIRE GI Panel is a syndromic PCR test that detecs the nucleid acids of bacteria, viruses and parasites commonly associated with infectious gastroenteritis from a stool sample.
C. difficile is a target included in the BIOFIRE GI Panel and is found in about 15% of positives. (know more).
It has been demonstrated that the BIOFIRE GI Panel can lead to more rational patient isolation, lowering the rates of nosocomial transmission of many GI pathogens, it can also detect unsuspected infections in C. difficile negative patients7.
In addition using a standalone nucleic acid amplification test (NAAT), like the BIOFIRE GI Panel, could lead to implementation of a treatment that is beneficial to some patients, even if the toxin immunoassay tests are negative.8.
VIDAS® C. difficile panel
VIDAS® C. difficile GDH is a qualitative test that detects the C. difficile antigen, glutamate dehydrogenase (GDH), in stool specimens to screen patients suspected of having C. difficile infection. It is used in conjunction with VIDAS® C. difficile Toxin A&B as part of a two-step algorithm.
VIDAS® C. difficile immunoassays are adapted to current diagnosis guidelines9 with:
- VIDAS® GDH highly sensitive test for the screening
- VIDAS® CDAB highly specific test for the toxins detection.
VIDAS® GDH and VIDAS® CDAB are CE marked under the in vitro diagnostic medical devices regulation (EU) 2017/746
CHROMID® C.difficile
For epidemiology purpose or outbreak management the culture of Clostridioides difficile remains necessary.
CHROMID® C.difficile highlights pathogens of interest within 24h and reduces unnecessary confirmation tests and incubation time!
EPISEQ® CS for clinical pathogens outbreak monitoring
Next Generation Sequencing software to determine the transmission pathway in case of C. difficile outbreak. EPISEQ® CS includes a highly discriminant bacterial typing technics based on raw Whole Genome Sequencing data and delivers the list of resistance and virulence genes present on the bacterial genome.
EPISEQ® CS is not for diagnostic use
EPISEQ® 16S for microbiome profiling studies
EPISEQ® 16S determines the microbial composition of stools samples based on the 16S rRNA gene. It helps to monitor the microbial flora from dysbiosis towards the recovery of a healthy microbiota in case CDI or to monitor to impact of antibiotics treatment of the stool's microbiota. EPISEQ® 16S helps to characterize a donor’s microbiota in the process of Fecal Microbiota Transplant and assess the presence of C. difficile.
CDIs are an important HAI, and need to be monitored, as part of the Anti-Microbial Stewardship program of your institution.
Discover our booklet on CDIs ”Clostridioides difficile infections, from Diagnosis to Outbreak Management”
References:
- CDC’s 2019 Antibiotic Resistance Threats Report.
- Gupta A, Ananthakrishnan AN. Economic burden and cost-effectiveness of therapies for Clostridiodes difficile infection: a narrative review. Therap Adv Gastroenterol. 2021 May 30;14:17562848211018654. doi: 10.1177/17562848211018654. PMID: 34104214; PMCID: PMC8170348.
- Kelly, C. R., et al. (2021). "ACG Clinical Guidelines: Prevention, Diagnosis, and Treatment of Clostridioides difficile Infections." Am J Gastroenterol 116(6): 1124-1147.
- Viprey, V. F., et al. (2022). "A point-prevalence study on community and inpatient Clostridioides difficile infections (CDI): results from Combatting Bacterial Resistance in Europe CDI (COMBACTE-CDI), July to November 2018." Euro Surveill 27(26).
- McDonald, L. C., et al. (2018). "Clinical Practice Guidelines for Clostridium difficile Infection in Adults and Children: 2017 Update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA)." Clin Infect Dis 66(7): e1-e48.
- Crobach, M. J., et al. (2016). "European Society of Clinical Microbiology and Infectious Diseases: update of the diagnostic guidance document for Clostridium difficile infection." Clin Microbiol Infect 22 Suppl 4: S63-81.
- Rand, K. H., et al. (2015). "Multiplex gastrointestinal pathogen panels: implications for infection control." Diagn Microbiol Infect Dis 82(2): 154-157.
- Prosty, C., et al (2023). "Clinical Outcomes and Management of NAAT-Positive/Toxin-Negative Clostridioides difficile Infection: A Systematic Review and Meta-Analysis." Clin Infect Dis
- https://journals.lww.com/ajg/fulltext/2021/06000/acg_clinical_guidelines__prevention,_diagnosis,.12.aspx
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