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Comment & Response |

Toxin Immunoassays and Clostridium difficile Infection

Geraldine Moloney, MB, MRCPI1; Brian O'Connell, MD, FRCPath2; Thomas R. Rogers, FRCPI, FRCPath3
[+] Author Affiliations
1Department of Clinical Microbiology, Trinity College Dublin, Clinical Microbiology, Dublin, DO8 RX0X, Ireland
2Department of Clinical Microbiology, St James's Hospital
3Department of Clinical Microbiology, Trinity College Dublin, Trinity College Dublin, St James's Hospital, Dublin Dublin 8, Ireland
JAMA Intern Med. 2016;176(3):413-414. doi:10.1001/jamainternmed.2015.8536.
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To the Editor We read with interest the recent article in JAMA Internal Medicine by Polage et al,1 who report on the outcomes of Clostridium difficile infection (CDI), using a laboratory diagnostic strategy of either combined toxin enzyme immunoassay and polymerase chain reaction (PCR) assay results or on the basis of the PCR assay result alone. Their conclusion was that patients with only a positive PCR (PCR+) result had outcomes similar to patients without C difficile infection and that exclusive reliance on molecular tests for CDI diagnosis is likely to result in overdiagnosis and overtreatment.

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March 1, 2016
Niaz Banaei, MD; Lee Frederick Schroeder, MD, PhD
1Department of Pathology, Stanford University School of Medicine, California2Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, California3Clinical Microbiology Laboratory, Stanford Health Care, California
4Department of Pathology, University of Michigan School of Medicine, Ann Arbor
JAMA Intern Med. 2016;176(3):413. doi:10.1001/jamainternmed.2015.8525.
March 1, 2016
Christopher R. Polage, MD, MAS; Jay V. Solnick, MD, PhD; Stuart H. Cohen, MD
1Department of Pathology and Laboratory Medicine, University of California Davis School of Medicine, Sacramento, California2Division of Infectious Diseases, Department of Internal Medicine, University of California Davis School of Medicine, Sacramento, California
2Division of Infectious Diseases, Department of Internal Medicine, University of California Davis School of Medicine, Sacramento, California3Department of Medical Microbiology and Immunology, University of California Davis School of Medicine, Sacramento, California
2Division of Infectious Diseases, Department of Internal Medicine, University of California Davis School of Medicine, Sacramento, California
JAMA Intern Med. 2016;176(3):414-415. doi:10.1001/jamainternmed.2015.8539.
March 1, 2016
Ferric C. Fang, MD
1Departments of Laboratory Medicine and Microbiology, University of Washington School of Medicine, Seattle
JAMA Intern Med. 2016;176(3):412. doi:10.1001/jamainternmed.2015.8522.
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