Ann Clin Microbiol.  2023 Sep;26(3):75-82. 10.5145/ACM.2023.26.3.5.

A survey of physicians’ perceptions of diagnostic tests for Clostridioides difficile infection

• Chung HS
• Kim YS
• Cho YS
• Park JS
• Shin BM

• KMID: 2550658
• DOI: http://doi.org/10.5145/ACM.2023.26.3.5

Abstract

Background
This study aimed to investigate perceptions of Clostridioides difficile infection (CDI) diagnostic tests among physicians who prescribe CDI diagnostic tests as part of providing direct patient care.
Methods
In August 2018, we provided a 12-question survey of gastroenterologists (the most common referral source for CDI testing) to 35 medical institutions in Korea, asking them about their perceptions of CDI diagnosis and testing.
Results
A comparison of the perceptions of physicians and clinical pathologists (CPs) found that physicians had a lower perceived sensitivity of the toxin AB enzyme immunoassay test. For nucleic acid amplification tests, physicians exhibited a perception of higher assay sensitivity and specificity than CPs. The specificity of culture tests was generally perceived as high by physicians, whereas CPs regarding expressed mixed opinions. All but one physician and one CPs found the algorithmic test useful. Concerning the CDI isolation criteria, physicians commenced patient isolation by concurrently assessing both test results and clinical symptoms, rather than exclusively relying upon test results. Among CPs, 84.6% said they could rely on symptoms to determine when to release a patient from isolation, while 46.2% of physicians said they would rely on test results.
Conclusion
This study provides useful information on the status of laboratory diagnosis of CDI in Korea and what needs to be improved, which will help to standardize and improve laboratory diagnosis of CDI in Korea.

Keyword

Clostridioides difficile Infection; Diagnostic test; Physician; Survey

Figure

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  Fig. 1. Comparison of perceptions of the sensitivity and specificity of diagnostic tests for Clostridioides difficile infection among physicians and clinical pathologists. EIA, enzyme immunoassay; NAAT, nucleic acid amplification test.

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