• José F García-Fuentes, Brenda J Torres-Murillo, Gilberto Aguilar-Orozco, Élida González, Juan L Mosqueda, Alejandro E Macías, and José A Álvarez.
• Microbiology Laboratory, Department of Medicine and Nutrition, Universidad de Guanajuato, Guanajuato.
• Gac Med Mex. 2021 Jan 1; 157 (1): 107-109.

IntroductionClostridioides difficile causes diarrhea and pseudomembranous colitis. Its diagnosis is made with glutamate dehydrogenase (GDH) or toxins A and B detection and is confirmed with nucleic acid amplification tests.ObjectiveTo define if GDH determination is redundant to that of toxins.MethodsRetrospective, observational study in diarrheal stools of patients with suspected Clostridioides difficile infection. Toxins and GDH were determined by immunochromatography. Bayesian simulation was performed with likelihood ratios; a p-value < 0.05 was regarded as significant.Results329 GDH and toxin A and B results were analyzed. Clostridioides difficile infection prevalence was 18.2 %. Sensitivity and specificity of the GDH test were 0.90 and 0.89, respectively. Positive likelihood ratio was 8.9, and negative was 0.11.ConclusionsA negative GDH result considerably reduces the probability of infection but does not rule it out. Clostridioides difficile toxins detection may be necessary in institutions where nucleic acid amplification is not affordable or accessible.Copyright: © 2020 Permanyer.

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