Kinetics of polymerase chain reaction positivity in patients with infection
Background: Polymerase chain reaction (PCR) is a sensitive test for diagnosing Clostridioides difficile infection (CDI) and could remain positive following resolution of CDI. The kinetics of PCR positivity following antibiotics for CDI is unknown. We studied this and whether it predicted CDI recurre...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2021-10-01
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| Series: | Therapeutic Advances in Gastroenterology |
| Online Access: | https://doi.org/10.1177/17562848211050443 |
| _version_ | 1818582540203589632 |
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| author | Srishti Saha Devvrat Yadav Ryan Pardi Robin Patel Sahil Khanna Darrell Pardi |
| author_facet | Srishti Saha Devvrat Yadav Ryan Pardi Robin Patel Sahil Khanna Darrell Pardi |
| author_sort | Srishti Saha |
| collection | DOAJ |
| description | Background: Polymerase chain reaction (PCR) is a sensitive test for diagnosing Clostridioides difficile infection (CDI) and could remain positive following resolution of CDI. The kinetics of PCR positivity following antibiotics for CDI is unknown. We studied this and whether it predicted CDI recurrence. Methods: Adults with CDI from October 2009 to May 2017 were included. Serial stool samples within 60 days of treatment were collected. Recurrent CDI was defined as diarrhea after interim symptom resolution with positive stool PCR within 56 or 90 days of treatment completion. Contingency table analysis was used to assess the risk of recurrence. Results: Fifty patients were included [median age: 51 (range = 20–86) years, 66% women]. Treatment given was metronidazole, 50% (25); vancomycin, 44% (22); both, 4% (2); and fidaxomicin, 2% (1). Median duration of treatment for all 50 patients was 14 (range = 8–60) days. The median duration of treatment in patients who got prolonged therapy (>14 days) ( n = 10) was 47 (range = 18–60) days. Median time to negative PCR was 9 (95% CI, 7–14) days from treatment initiation, which did not differ by antibiotics given ( p = 0.5). A positive PCR during or after treatment was associated with a higher risk of recurrence at 56 days ( p = 0.02) and at 90 days ( p = 0.009). Conclusion: The median time to negative PCR in CDI was 9 days from treatment initiation. The PCR positivity during or after treatment may be useful for recurrence prediction; larger studies are needed to validate these results. |
| first_indexed | 2024-12-16T07:51:00Z |
| format | Article |
| id | doaj.art-00bf001f2d164c5cb1966fc4ab0c7b8f |
| institution | Directory Open Access Journal |
| issn | 1756-2848 |
| language | English |
| last_indexed | 2024-12-16T07:51:00Z |
| publishDate | 2021-10-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Therapeutic Advances in Gastroenterology |
| spelling | doaj.art-00bf001f2d164c5cb1966fc4ab0c7b8f2022-12-21T22:38:52ZengSAGE PublishingTherapeutic Advances in Gastroenterology1756-28482021-10-011410.1177/17562848211050443Kinetics of polymerase chain reaction positivity in patients with infectionSrishti SahaDevvrat YadavRyan PardiRobin PatelSahil KhannaDarrell PardiBackground: Polymerase chain reaction (PCR) is a sensitive test for diagnosing Clostridioides difficile infection (CDI) and could remain positive following resolution of CDI. The kinetics of PCR positivity following antibiotics for CDI is unknown. We studied this and whether it predicted CDI recurrence. Methods: Adults with CDI from October 2009 to May 2017 were included. Serial stool samples within 60 days of treatment were collected. Recurrent CDI was defined as diarrhea after interim symptom resolution with positive stool PCR within 56 or 90 days of treatment completion. Contingency table analysis was used to assess the risk of recurrence. Results: Fifty patients were included [median age: 51 (range = 20–86) years, 66% women]. Treatment given was metronidazole, 50% (25); vancomycin, 44% (22); both, 4% (2); and fidaxomicin, 2% (1). Median duration of treatment for all 50 patients was 14 (range = 8–60) days. The median duration of treatment in patients who got prolonged therapy (>14 days) ( n = 10) was 47 (range = 18–60) days. Median time to negative PCR was 9 (95% CI, 7–14) days from treatment initiation, which did not differ by antibiotics given ( p = 0.5). A positive PCR during or after treatment was associated with a higher risk of recurrence at 56 days ( p = 0.02) and at 90 days ( p = 0.009). Conclusion: The median time to negative PCR in CDI was 9 days from treatment initiation. The PCR positivity during or after treatment may be useful for recurrence prediction; larger studies are needed to validate these results.https://doi.org/10.1177/17562848211050443 |
| spellingShingle | Srishti Saha Devvrat Yadav Ryan Pardi Robin Patel Sahil Khanna Darrell Pardi Kinetics of polymerase chain reaction positivity in patients with infection Therapeutic Advances in Gastroenterology |
| title | Kinetics of polymerase chain reaction positivity in patients with infection |
| title_full | Kinetics of polymerase chain reaction positivity in patients with infection |
| title_fullStr | Kinetics of polymerase chain reaction positivity in patients with infection |
| title_full_unstemmed | Kinetics of polymerase chain reaction positivity in patients with infection |
| title_short | Kinetics of polymerase chain reaction positivity in patients with infection |
| title_sort | kinetics of polymerase chain reaction positivity in patients with infection |
| url | https://doi.org/10.1177/17562848211050443 |
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