Detection of toxigenic Clostridium difficile colonization in patients admitted to the hospital for chemotherapy or haematopoietic cell transplantation

John L. Vaughn; Joan-Miquel Balada-Llasat; Misty Lamprecht; Ying Huang; Mirela Anghelina; Zeinab El Boghdadly; Karen Bishop-Hill; Rachel Childs; Preeti Pancholi; Leslie A. Andritsos

doi:10.1099/jmm.0.000774

Volume 67, Issue 7

Research Article

Open Access

Detection of toxigenic Clostridium difficile colonization in patients admitted to the hospital for chemotherapy or haematopoietic cell transplantation

John L. Vaughn¹, Joan-Miquel Balada-Llasat², Misty Lamprecht³, Ying Huang¹, Mirela Anghelina³, Zeinab El Boghdadly⁴, Karen Bishop-Hill⁴, Rachel Childs⁵, Preeti Pancholi^2,† and Leslie A. Andritsos^1,†
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Affiliations: ¹ Division of Hematology, The Ohio State University Wexner Medical Center, Columbus, OH, USA ² Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, OH, USA ³ Comprehensive Cancer Center, The Ohio State University Wexner Medical Center, Columbus, OH, USA ⁴ Division of Infectious Diseases, The Ohio State University Wexner Medical Center, Columbus, OH, USA ⁵ Nursing Research, The Ohio State University Wexner Medical Center, Columbus, OH, USA
*Correspondence: John L. Vaughn, [email protected] Preeti Pancholi, [email protected]

† These authors contributed equally to this work.
Published: 01 July 2018 https://doi.org/10.1099/jmm.0.000774

Abstract

Increasing evidence suggests that asymptomatic carriers are an important source of healthcare-associated Clostridium difficile infection. However, it is not known which test for the detection of C. difficile colonization is most sensitive in patients with haematological malignancies. We performed a prospective cohort study of 101 patients with haematological malignancies who had been admitted to the hospital for scheduled chemotherapy or haematopoietic cell transplantation. Each patient provided a formed stool sample. We compared the performance of five different commercially available assays, using toxigenic culture as the reference method. The prevalence of toxigenic C. difficile colonization as determined by toxigenic culture was 14/101 (14 %). The Cepheid Xpert PCR C. difficile/Epi was the most sensitive test for the detection of toxigenic C. difficile colonization, with 93 % sensitivity and 99 % negative predictive value. Our findings suggest that the Xpert PCR C. difficile/Epi could be used to rule out toxigenic C. difficile colonization in this population.

Received: 21/03/2018
Accepted: 21/05/2018
Published Online: 01/07/2018

Keyword(s): chemotherapy , Clostridium difficile , colonization and haematopoietic cell transplantation

This is an open access article under the terms of the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.

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Detection of toxigenic Clostridium difficile colonization in patients admitted to the hospital for chemotherapy or haematopoietic cell transplantation

J. Med. Microbiol. 67, 976 (2018); https://doi.org/10.1099/jmm.0.000774

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Volume 67, Issue 7

Research Article

Open Access

Detection of toxigenic Clostridium difficile colonization in patients admitted to the hospital for chemotherapy or haematopoietic cell transplantation

Abstract

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