Polymerase chain reaction testing for Clostridium difficile

Abstract

The publication in testing for Clostridium difficile is very interesting.1Catanzaro M. Cirone J. Real-time polymerase chain reaction testing for Clostridium difficile reduces isolation time and improves patient management in a small community hospital.Am J Infect Control. December 6, 2011; (Epub ahead of print)PubMed Google Scholar Catanzaro and Cirone concluded that “PCR testing is a viable option for small community hospitals, providing accurate and timely results for patient management and infection control.”1Catanzaro M. Cirone J. Real-time polymerase chain reaction testing for Clostridium difficile reduces isolation time and improves patient management in a small community hospital.Am J Infect Control. December 6, 2011; (Epub ahead of print)PubMed Google Scholar This conclusion might or might not be correct. It is no doubt that polymerase chain reaction (PCR) testing can reduce the turnaround time, but its cost is very high compared with standard testing. Based on this testing, there is no cost identification, and there is also no cost-utility analysis. Although there is no previous medical economic analysis on PCR testing for C difficile, a recent publication showed that it is still doubtful that PCR testing for Clostridium perfringens in disease control is cost-effective.2Abubakar I. Irvine L. Aldus C.F. Wyatt G.M. Fordham R. Schelenz S. et al.A systematic review of the clinical, public health and cost-effectiveness of rapid diagnostic tests for the detection and identification of bacterial intestinal pathogens in faeces and food.Health Technol Assess. 2007; 11: 1-216PubMed Google Scholar The publication in testing for Clostridium difficile is very interesting.1Catanzaro M. Cirone J. Real-time polymerase chain reaction testing for Clostridium difficile reduces isolation time and improves patient management in a small community hospital.Am J Infect Control. December 6, 2011; (Epub ahead of print)PubMed Google Scholar Catanzaro and Cirone concluded that “PCR testing is a viable option for small community hospitals, providing accurate and timely results for patient management and infection control.”1Catanzaro M. Cirone J. Real-time polymerase chain reaction testing for Clostridium difficile reduces isolation time and improves patient management in a small community hospital.Am J Infect Control. December 6, 2011; (Epub ahead of print)PubMed Google Scholar This conclusion might or might not be correct. It is no doubt that polymerase chain reaction (PCR) testing can reduce the turnaround time, but its cost is very high compared with standard testing. Based on this testing, there is no cost identification, and there is also no cost-utility analysis. Although there is no previous medical economic analysis on PCR testing for C difficile, a recent publication showed that it is still doubtful that PCR testing for Clostridium perfringens in disease control is cost-effective.2Abubakar I. Irvine L. Aldus C.F. Wyatt G.M. Fordham R. Schelenz S. et al.A systematic review of the clinical, public health and cost-effectiveness of rapid diagnostic tests for the detection and identification of bacterial intestinal pathogens in faeces and food.Health Technol Assess. 2007; 11: 1-216PubMed Google Scholar Real-time polymerase chain reaction testing for Clostridium difficile reduces isolation time and improves patient management in a small community hospitalAmerican Journal of Infection ControlVol. 40Issue 7PreviewThe impact of a switch from a toxin A/B enzyme immunoassay (EIA) to a polymerase chain reaction (PCR) method for detection of toxigenic Clostridium difficile was assessed for C difficile infection (CDI) rates, patient isolation-days, and CDI-related treatment. Full-Text PDF Polymerase chain reaction testing for Clostridium difficileAmerican Journal of Infection ControlVol. 40Issue 6PreviewWe believe the conclusion that polymerase chain reaction detection of toxigenic Clostridium difficile is viable for a small community hospital is accurate because it was successfully implemented in our setting and resulted in benefits including decreased length of stay in isolation, tests ordered, and empiric antimicrobial therapy.1 We acknowledge that a formal cost analysis was beyond the scope of the study and, therefore, that our results may not be generalized to all small community hospitals. Full-Text PDF