Clostridium difficile Infection (CDI): Overview, Laboratory Tests and Updated Guidelines. (Online Course)

David J. Moffa, Ph.D. BCLD
Reviewer: Lorna Ruskin, Ed.D, MT(ASCP)

This course discusses the characteristics and properties of the Clostridium difficile bacterium; its presence in the intestinal tract, toxins A and B, and the aggressive 027 strain. Health care facts and statistics, signs and symptoms, and causes, risk factors and complications of Clostridium difficile infections (CDI) are covered. You will be introduced to the treatments and prevention of CDI and discuss the most effective antibiotic treatments along with commercially-available laboratory tests for CDI. The latest updated IDSA/SHEA guidelines and recommendations on the multistep algorithm for diagnosis, laboratory testing and treatment of CDI are also discussed.

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Continuing Education Credits

  • P.A.C.E.® Contact Hours: 1 hour(s)
  • Florida Board of Clinical Laboratory Science CE - General (Microbiology/Mycology/Parasitology): 1 hour(s)

Objectives

  • Discuss the characteristics and properties of the Clostridium difficile bacterium; its presence in the intestinal tract, toxins A and B, and the aggressive 027 strain
  • Describe the health care facts and statistics on Clostridium difficile infection (CDI).
  • Recognize the symptoms and severity of CDI. Differentiate mild to moderate, severe, fulminant and recurrent CDI’s.
  • Differentiate mild to moderate, severe, fulminant and recurrent CDI’s.
  • Identify the causes, risk factors and complications of CDI. Explain antibiotic-associated CDI.
  • Describe the treatments and prevention of CDI and discuss the most effective antibiotic treatments
  • Discuss the differential diagnosis of CDI and the various types of lab tests available.
  • Give an overview of the commercially-available laboratory tests for CDI.
  • Summarize the latest updated IDSA/SHEA guidelines and recommendations on the multistep algorithm for diagnosis, laboratory testing and treatment of CDI.

Course Outline

  • Clostridium difficile infection (CDI): The C difficile bacterium
      • Clostridium difficile: The bacterium
      • Clostridium difficile strains and toxins
      • Emerging New Clostridium difficile Strain: “The 027 Strain”
      • Which of the following describe(s) the Clostridium difficile bacterium?
      • Pathogenic C diff strains can produce multiple toxins. Which statement(s) is (are) correct regarding these toxins?
      • A hypervirulent strain, commonly referred to as "strain 027" is an aggressive strain of Clostridium difficile that produces more toxins and is more re...
  • CDI: Healthcare Facts and Statistics
      • CDI: Healthcare Facts and Statistics
  • CDI: Symptoms and Severity
      • CDI: Symptoms and Severity
      • CDI: Symptoms and Severity (continued)
      • CDI: Symptoms and Severity (continued)
      • When describing CDI, which of the following statements is (are) correct?
      • Using white blood cell counts and creatinine levels may help clinicians classify the severity of CDI. If the white blood cell count is <15,000 and ...
      • The risk of a recurrence of CDI is usually higher if the individual is older than 65 and taking other antibiotics while being treated for CDI.
  • CDI: Causes , Risk Factors, and Complications
      • CDI: Causes , Risk Factors, and Complications
      • CDI: Risk Factors for CDI
      • CDI: Complications of CDI
      • Which statement(s) is (are) true relative to the cause of CDI?
  • CDI: Treatment and Prevention
      • CDI: Treatment
      • CDI: Prevention
      • Which statement is not true relative to the treatment of CDI?
  • Diagnosis of CDI: Laboratory Methods
      • Diagnosis of CDI: Overview and Challenges
      • Diagnosis of CDI: Overview and Challenges (continued)
      • Traditionally, CDI is diagnosed in a patient by using which of the following?
      • Diagnosis of CDI: Laboratory Methods
      • Diagnosis of CDI: Laboratory Methods (continued)
      • Diagnosis of CDI: Laboratory Methods (continued)
      • Laboratory-based tests to help diagnose CDI typically examine a serum or blood sample for certain toxins and/or specific enzyme antigen produced by th...
      • Fill in the blank: The cell culture _______________ assay analyzes the effects of the C diff toxin on human cells grown in a culture. This assay has i...
      • Match the laboratory method with the method description.
      • Laboratory Methods: Overview of Diagnostic Approach
      • Laboratory Methods: Diagnostic Approach
      • CDI should be suspected in a patient with acute diarrhea (> 3 loose stools in 24 hours) with no obvious explanation for the diarrhea especially wit...
      • Which statement(s) is (are) true when discussing the approach to diagnosing CDI?
  • CDI: Commercially-available Laboratory Tests
      • Commercially-Available Tests: Overview
      • Commercially-Available Tests: The Xpect C Difficile Test
      • The Xpect® C. Difficile Toxin A/B Test (continued)
      • The Xpect® C. Difficile Toxin A/B Test (continued)
      • Commercially-available testing for CDI currently favors the employment of a rapid, technologically simple and low cost assay.
      • The following information correctly describes the Xpect® C difficile Toxin A/B test.
      • Commercially-Available Tests: The C. DIFF QUIK CHEK COMPLETE®
      • The C. DIFF QUIK CHEK COMPLETE® (continued)
      • The C. DIFF QUIK CHEK COMPLETE® (continued)
      • The C. DIFF QUIK CHEK COMPLETE® (continued)
      • Which of the following selection(s) describe the C Diff Quik Chek Complete® test?
      • A C Diff Quik Chek Complete® test result showed vertical blue lines on both the "Ag line" and "Toxin line" with a vertical dotted blue line on th...
  • Updated IDSA/SHEA guidelines and recommendations for the diagnosis, laboratory testing and treatment of CDI.
      • Overview and summary of IDSA/SHEA guidelines
      • Updated IDSA/SHEA Guidelines/Recommendations: Multistep Algorithm For Accurate Testing
      • What key changes are included in the new updated IDSA and SHEA guidelines for the diagnosis and treatment of CDI?
      • Which of the following are recommended 2018 IDSA/SHEA guidelines on diagnostic testing for CDI?
  • Summary
      • Summary
  • References
      • References

Additional Information

Level of instruction: Intermediate

Intended Audience: Clinical laboratory professionals including medical laboratory scientists, medical technologists, and technicians. This course is also appropriate for clinical laboratory science and MLT students, pathologists, and clinicians.
Author information: David J. Moffa, PhD, BCLD, has over 30 years of experience in the healthcare industry as an executive manager, clinical laboratory director, and medical laboratory scientist. He is currently a technical consultant for Kentmere Healthcare, Wilmington, DE, and until his retirement, was the Regional Director for LabCorp, Inc. He holds a PhD in medical biochemistry from the School of Medicine, West Virginia University.
Reviewer information:  Lorna Ruskin, EdD, MT(ASCP) is an Assistant Professor for the Medical Laboratory Science program at the University of Minnesota. Lorna has approximately 20 years of teaching experience in Medical Laboratory Science programs and has served as both the Program Director and Clinical Coordinator. She has done extensive research on laboratory simulation and has presented at national conferences regarding that topic.
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