Experience with PCR Testing for Enteric Bacteria and Viruses of Emergency Department Patients with Acute Gastroenteritis: Are There Implications for the Early Treatment of <i>Clostridioides difficile</i> Infection?

Early identification of acute gastroenteritis (AGE) pathogens via PCR may improve the management of patients presenting to the emergency department (ED). In this study, we evaluated the implementation of a testing algorithm for ED patients with AGE using the BD MAX automated PCR system. Data from 13...

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Bibliographic Details
Main Authors: Andreas Iffland, Maria Zechel, Jan-Christoph Lewejohann, Birgit Edel, Stefan Hagel, Michael Hartmann, Bettina Löffler, Jürgen Rödel
Format: Article
Language:English
Published: MDPI AG 2024-03-01
Series:Antibiotics
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Online Access:https://www.mdpi.com/2079-6382/13/3/243
Description
Summary:Early identification of acute gastroenteritis (AGE) pathogens via PCR may improve the management of patients presenting to the emergency department (ED). In this study, we evaluated the implementation of a testing algorithm for ED patients with AGE using the BD MAX automated PCR system. Data from 133 patients were analyzed. A total of 56 patients (42%) tested positive via PCR for at least one bacterial or viral pathogen. The median time to report PCR results was 6.17 h compared to 57.28 h for culture results for bacterial pathogens. The most common pathogen was <i>Clostridioides difficile</i> (<i>n</i> = 20, 15%). In total, 14 of the 20 <i>C. difficile</i>-positive patients were aged >65 years and 17 of the 20 patients (85%) were diagnosed with a clinically relevant infection based on typical symptoms and laboratory values. They received antibiotics, mostly oral vancomycin, starting a median of 11.37 h after ED admission. The introduction of PCR for the diagnosis of AGE infection in patients presenting to the ED may have the greatest impact on the rapid identification of <i>C. difficile</i> and the timely administration of antibiotics if necessary.
ISSN:2079-6382