J Korean Med Sci.  2022 Feb;37(5):e38. 10.3346/jkms.2022.37.e38.

Nationwide Survey for Current Status of Laboratory Diagnosis of Clostridioides difficile Infection in Korea

• Chung HS
• Park JS
• Shin BM
• Yoo HM
• Kim H
• Cho J
• Lee CH
• Ryoo NH
• Kim JS
• Chung JW
• Hong KH
• Kim YS
• Cho YS

• KMID: 2525490
• DOI: http://doi.org/10.3346/jkms.2022.37.e38

Abstract

Background
The interest in Clostridioides difficile infection (CDI) has increased, and the choice of assays became wider since the first national survey in Korea on CDI diagnosis in 2015. We conducted a survey of the domestic CDI assays with more varied questions to understand the current situation in Korea.
Methods
In April 2018, about 50 questions on the current status of CDI assays and details on implementation and perceptions were written, and a survey questionnaire was administered to laboratory medicine specialists in 200 institutions.
Results
One-hundred and fifty institutions responded to the questionnaire, of which 90 (60.0%) including one commercial laboratory, performed CDI assays. The toxin AB enzyme immunoassay (toxin AB EIA), nucleic acid amplification test (NAAT), and C. difficile culture, glutamate dehydrogenase assay, alone or in combination with other assays, were used in 75 (84.3%), 52 (58.4%), 35 (36.0%), and 23 (25.8%), respectively, and 65 (73.0%) institutions performed a combination of two or more assays. The sensitivity of toxin AB EIA was more negatively perceived, and that on specificity was more positively perceived. The perception of sensitivity and specificity of NAAT was mostly positive. Perception on the algorithm test projected it as useful but in need of countermeasures. Sixty-three (73.3%) institutions responded that they performed surveillance on CDI.
Conclusion
This study provides useful evidence on the current status of CDI laboratory diagnosis in Korea as well as on items that require improvement and is thought to aid in standardizing and improving the CDI laboratory diagnosis in Korea.

Keyword

Clostridioides difficile Infection; Laboratory Diagnosis; Toxin AB Enzyme Immunoassay; Nucleic Acid Amplification Test; Culture; Glutamate Dehydrogenase; Survey

Figure

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  Fig. 1 The perception of the sensitivity and specificity of each Clostridioides difficile assays experienced by the laboratory medicine specialists.EIA = enzyme immunoassay, NAAT = nucleic acid amplification test, GDH = glutamate dehydrogenase.

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