1. Updated IDSA/SHEA guidelines published in 2018 recommend:
- Against the use of NAAT alone when there are no pre-agreed institutional criteria for patient stool submission, due to inadequate positive predictive value
- Use of a stool toxin test as part of a multi-step algorithm (ie, glutamate dehydrogenase [GDH] plus toxin; GDH plus toxin, arbitrated by nucleic acid amplification test [NAAT]; or NAAT plus toxin) for all specimens received in the clinical laboratory whether there are or are no pre-agreed institutional criteria for patient stool submission.
- Or screening samples simultaneously with both a GDH and toxin A/B EIA with an assay that includes both these targets in one system (C. DIFF QUIK CHEK COMPLETE®).
2. Updated ESCMID guidelines published in 2016 recommend:
- Against the use of a single rapid test as a standalone test, due to inadequate positive predictive value.
- The use of a 2-step algorithm starting with either GDH EIA or NAAT. Samples with a negative first test result can be reported as negative. Samples with a positive first test result should be tested further with a Toxin A & B EIA.
- Or screen samples simultaneously with both a GDH and toxin A/B EIA with an assay that includes both these targets in one system (C. DIFF QUIK CHEK COMPLETE®).
3. C. DIFF QUIK CHEK COMPLETE® Package Insert
