Table 3.
Testing indications and diagnostic testing methods by regional groups for travel-associated C. difficile infection at GeoSentinel sites (n = 56)
| Testing approaches1 | Europe (n = 21) | North America (n = 19) | Other (n = 16) | Total (n = 56) | |
|---|---|---|---|---|---|
| All or most patients with acute diarrhoea are tested | 2 (10%) | 5 (26%) | 2 (13%) | 9 | |
| Any patient with acute diarrhoea who failed empiric treatment for presumed bacterial diarrhoea | 7 (33%) | 5 (26%) | 3 (19%) | 15 | |
| Patients with acute diarrhoea and risk factors for (recent antibiotic exposure, healthcare exposure) | 18 (86%) | 13 (68%) | 11 (69%) | 42 | |
| All or most patients with chronic diarrhoea | 7 (33%) | 8 (42%) | 4 (25%) | 19 | |
| Patients with chronic diarrhoea and risk factors for (recent antibiotic exposure, healthcare exposure) | 17 (81%) | 11 (58%) | 7 (44%) | 35 | |
| Patients with chronic diarrhoea who failed empiric treatment for presumed parasitic infection | 5 (24%) | 3 (16%) | 5 (31%) | 13 | |
| Elderly patients (age 65 or older) | 4 (19%) | 2 (11%) | 1 (6%) | 7 | |
| Patients with active malignancy or other immunocompromising condition | 6 (29%) | 2 (11%) | 2 (13%) | 10 | |
| Patients with evidence of organ dysfunction due to the severity of the infection (i.e. renal failure, etc) | 5 (24%) | 4 (21%) | 0 (0%) | 9 | |
| Testing practices vary by individual clinician at our GeoSentinel Site | 8 (38%) | 9 (47%) | 6 (38%) | 23 | |
|
| |||||
| C. difficile testing method2 | No. responses3 | Europe | North America | Other | Total |
|
| |||||
| C. difficile toxin antigen detection by EIA | 40 | 8 (53%) | 7 (50%) | 8 (73%) | 23 |
| C. difficile toxin PCR | 44 | 9 (56%) | 17 (94%) | 6 (60%) | 32 |
| C. difficile toxin assay by monolayer cell culture | 37 | 3 (19%) | 1 (8%) | 0 (0%) | 4 |
| C. difficile rapid bacterial antigen plus toxin assay combination testing | 40 | 9 (50%) | 4 (31%) | 5 (56%) | 18 |
| C. difficile toxin immunoassay | 36 | 1 (6%) | 1 (9%) | 1 (11%) | 3 |
1
Note that these answers are not mutually exclusive, thus percentages do not add up to 100.
2
Note that these testing methods are not mutually exclusive, since many sites have more than 1 testing method.
3
Responses could be Yes, No, or Unknown.