Diagnostic trends in Clostridium difficile detection in Finnish microbiology laboratories |
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| Affiliation: | 1. Department of Infectious Disease Surveillance and Control, National Institute for Health and Welfare (THL), PO Box 30, FI-00271 Helsinki, Finland;2. Institute of Dentistry, University of Turku, Turku, Finland;1. Chongqing Key Laboratory of Forage & Herbivorce, College of Animal Science and Technology, Southwest University, Chongqing 400715, People’s Republic of China;2. Kansas State University, Manhattan, KS66506, USA;1. State Key Laboratory of Animal Nutrition, Ministry of Agriculture Feed Industry Centre, China Agricultural University, Beijing, People’s Republic of China;2. Animal Nutrition Institute, Sichuan Agricultural University, Key Laboratory of Animal Disease-Resistance Nutrition, Ministry of Education, Ya’an, People’s Republic of China;1. University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Department of Psychiatry, (CC-72), PO Box 30.001, 9700 Groningen, The Netherlands;2. University of Groningen, Heijmans Institute of Psychological Research, Groningen, The Netherlands;3. University of Amsterdam, Department of Clinical Psychology, Amsterdam, The Netherlands;1. Children’s Mercy Hospital, 610 E. 22nd St., Kansas City, MO 64108, USA;2. University of California, San Diego, 9500 Gilman Dr., La Jolla, CA 92093, USA;3. Arizona State University, 500 N. Third St., Phoenix, AZ 85006, USA |
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| Abstract: | Due to increased interest directed to Clostridium difficile-associated infections, a questionnaire survey of laboratory diagnostics of toxin-producing C. difficile was conducted in Finland in June 2006. Different aspects pertaining to C. difficile diagnosis, such as requests and criteria used for testing, methods used for its detection, yearly changes in diagnostics since 1996, and the total number of investigations positive for C. difficile in 2005, were asked in the questionnaire, which was sent to 32 clinical microbiology laboratories, including all hospital-affiliated and the relevant private clinical microbiology laboratories in Finland. The situation was updated by phone and email correspondence in September 2008. In June 2006, 28 (88%) laboratories responded to the questionnaire survey; 24 of them reported routinely testing requested stool specimens for C. difficile. Main laboratory methods included toxin detection (21/24; 88%) and/or anaerobic culture (19/24; 79%). In June 2006, 18 (86%) of the 21 laboratories detecting toxins directly from feces, from the isolate, or both used methods for both toxin A (TcdA) and B (TcdB), whereas only one laboratory did so in 1996. By September 2008, all of the 23 laboratories performing diagnostics for C. difficile used methods for both TcdA and TcdB. In 2006, the number of specimens processed per 100,000 population varied remarkably between different hospital districts. In conclusion, culturing C. difficile is common and there has been a favorable shift in toxin detection practice in Finnish clinical microbiology laboratories. However, the variability in diagnostic activity reported in 2006 creates a challenge for national monitoring of the epidemiology of C. difficile and related diseases. |
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