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【资讯翻译】Clinical Characteristics of Patients Who Test Positive for ...

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发表于 2014-10-21 09:59:43 | 显示全部楼层 |阅读模式
Clinical Characteristics of Patients Who Test Positive for Clostridium difficile by Repeat PCR

The high sensitivity of PCR assays for diagnosing Clostridium difficile infection (CDI) has greatly reduced the need for repeat testing after a negative result. Nevertheless, a small subset of patients do test positive within 7 days of a negative test. The aim of this study was to evaluate the clinical characteristics of these patients to determine when repeat testing may be appropriate. The results of all Xpert C. difficile PCR (Cepheid, Sunnyvale CA) tests performed in the clinical microbiology laboratory at New York-Presbyterian Hospital, Columbia University Medical Center (NYPH/CUMC) from 1 May 2011 through 6 September 2013, were reviewed. A retrospective case-control study was performed, comparing patients who tested positive within 7 days of a negative test result to a random selection of 50 controls who tested negative within 7 days of a negative test result. During the study period, a total of 14,875 tests were performed, of which 1,066 were repeat tests (7.2%). Eleven of these repeat tests results were positive (1.0%). The only risk factor independently associated with repeat testing positive was history of a prior CDI (odds ratio [OR], 19.6 [95% confidence interval {CI}, 4.0 to 19.5], P < 0.001). We found that patients who test positive for C. difficile by PCR within 7 days of a negative test are more likely to have a history of CDI than are patients who test negative with repeat PCR. This finding may be due to the high rate of disease relapse or the increased likelihood of empirical therapy leading to false-negative results in these patients.

信源地址:http://jcm.asm.org/content/52/11/3853.abstract

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发表于 2014-10-21 16:47:13 | 显示全部楼层

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发表于 2014-10-22 11:26:32 | 显示全部楼层
重复PCR诊断为艰难梭菌阳性的患者的临床特征

用于诊断艰难梭菌感染(CDI)的PCR检测灵敏度高,大大减少了阴性结果后重复检测的需要。然而,小部分患者在阴性结果后七天内检测呈阳性。本研究的目的是评估这些患者的临床特征,确定重复检测的最适时间。研究回顾了2011 年5月1日到2013年9月6日,在哥伦比亚大学医学中心(NYPH/CUMC)纽约长老会医院微生物检验科进行的,所有的Xpert艰难梭菌PCR检测结果(加州森尼韦尔,Cepheid公司)。进行了回顾性病例对照研究,对阴性结果后七天内检测呈阳性的患者和随机选择的50人对照组进行比较,对照组患者的阴性结果后七天内检测呈阴性。研究期内,共进行了14875次检测,其中1066次是重复检测(7.2%)。这些重复检测结果中11例呈阳性(1.0%)。与重复检测阳性独立相关的唯一风险因素是先前的CDI史(优势比[OR]:19.6[95%置信区间{CI}:4.0-19.5],P<0.001)。研究人员发现,阴性结果后七天内PCR检测艰难梭菌呈阳性的患者,比重复PCR检测呈阴性的患者,更可能有CDI史。这一发现可能是由于疾病复发率高,或经验性治疗导致这些患者出现假阴性结果的可能性增加。
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