What Are the Major Challenges Associated with Diagnosing CDI?

Ferric Fang, MD, professor, Lab Medicine/S.D., at the University of Washington, explains the major challenges associated with diagnosing Clostridium difficile infection.

Interview Transcript (modified slightly for readability):

“What are the major challenges to diagnosing [Clostridium difficile infection] CDI? The difficulty is not really in detecting toxigenic C. difficile, but in terms of its interpretation, because this is an organism that can cause asymptomatic colonization, self-limited disease, moderately severe disease, or life-threatening disease, and the diagnostic test can’t really tell you whether the patient has asymptomatic colonization or serious disease. So, this creates a lot of uncertainty about to interpret a test.

And one way to work around this is to look at the presence of the toxin, instead of the presence of the organism. And the presence of the toxin tends to correlate with a higher organism burden, but unfortunately, it doesn’t fall out neatly that the presence of the toxin tells you if you have disease. You can actually have toxin present and have colonization, or you can fail to detect toxin and have life-threatening disease. And so, there’s still this piece of the clinical assessment that is indispensable; it has to be the context in which the laboratory test is interpreted.”