Patients with discordant C. difficile test results had lower mortality with treatment
Patients who were positive for Clostridioides difficile on nucleic acid amplification testing but negative on toxin immunoassay had similar 30-day mortality to those with positive results on both tests, according to a review of observational studies.
Treatment was associated with a reduction in risk of mortality but not of recurrence among patients with discordant Clostridioides difficile test results, according to a recent review looking at C. difficile outcomes among symptomatic patients tested by both nucleic acid amplification tests (NAATs) and toxin immunoassays.
In the review, published by Clinical Infectious Diseases on Aug. 30, there was no significant difference in 30-day all-cause mortality between patients who were NAAT+/Toxin+ and those who were NAAT+/Toxin−, but risk of recurrence at 60 days in the former group was significantly higher (19.8% vs. 11.0%).
A more detailed summary of the study was published in the Sept. 13 ACP Hospitalist and a recent ACP Hospitalist feature article covered the challenge of optimizing C. diff testing. (ACP membership and ACP single sign-on required.)