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Laboratory Diagnostic Methods for Clostridioides difficile Infection: the First Systematic Review and Meta-analysis in Korea

Title
Laboratory Diagnostic Methods for Clostridioides difficile Infection: the First Systematic Review and Meta-analysis in Korea
Authors
Chung, Hae-SunPark, Jeong SuShin, Bo-Moon
Ewha Authors
정혜선
SCOPUS Author ID
정혜선scopus
Issue Date
2021
Journal Title
ANNALS OF LABORATORY MEDICINE
ISSN
2234-3806JCR Link

2234-3814JCR Link
Citation
ANNALS OF LABORATORY MEDICINE vol. 41, no. 2, pp. 171 - +
Keywords
Clostridioides difficileClostridioides difficile infectionLaboratory diagnostic methodsSystematic reviewMeta-analysis
Publisher
KOREAN SOC LABORATORY MEDICINE
Indexed
SCIE; SCOPUS; KCI WOS
Document Type
Review
Abstract
Background: Various methods are used for the diagnosis of Clostridioides difficile infection (CDI). We systematically analyzed and investigated the performance of current laboratory diagnostic methods for CDI. Methods: We performed systematic review and meta-analysis of studies in PubMed, Web of Science, Cochrane Library, and KoreaMed. The following methods were evaluated: glutamate dehydrogenase (GDH) enzyme immunoassays (GDH EIAs), toxin A and B detection by enzyme immunoassays (toxin AB EIAs), and nucleic acid amplification tests (NAATs) for C. difficile toxin genes. The sensitivity, specificity, positive predictive value (PPV). and negative predictive value (NPV) of each method were calculated. Results: Based on 39 studies, the pooled sensitivities/specificities were 92.7%/94.6%, 57.9%/97.0%, and 90.0%/95.8% for GDH EIAs, toxin AB EIAs, and NAATs, respectively, compared with those of toxigenic culture. The pooled sensitivities of automated EIAs were significantly higher than those of non-automated EIAs for both GDH and toxins A and B. The pooled sensitivity of Xpert C. difficile was significantly higher than those of other NAATs. PPVs increased as CDI prevalence increased, and NPVs were excellent when CDI prevalence was low; at CDI prevalence of 5%, PPV=37%-65% and NPV=97%-100%; at CDI prevalence of 50%, PPV=92%-97% and NPV= 65%-98%. Conclusions: Toxin AB EIAs still show unsatisfactory sensitivity, whereas GDH EIAs and NAATs show relatively high sensitivity. However, toxin AB EIAs are the most specific tests. This study may provide useful information for CDI diagnosis.
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DOI
10.3343/alm.2021.41.2.171
Appears in Collections:
의과대학 > 의학과 > Journal papers
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