• Nucleic acid amplification tests are the most recently marketed method for C. diff infection diagnosis.
• NAATs, though costly, offer rapid results and are sensitive compared to toxigenic culture.
• CDI diagnosis is based on clinical symptoms and laboratory tests.
• Patients with nosocomial diarrhea should be routinely tested for C. diff.
• Laboratory tests fall into three categories: tests that detect free toxins A and B in stool, tests that detect toxigenic strain and tests that detect the presence of C. diff in stool.
• Reference methods include stool cytotoxicity and toxigenic culture.
• Other methods include EIA tests, which can detect toxins and glutamate dehyrogenase produced by C. diff strains, and nucleic acid amplification tests, which are the most recently developed method.
• The debate surrounding diagnosis methods focuses on NAATs and TC, which are sensitive, but lack specificity, and tests detecting free toxins, which are specific, but lack sensitivity.
• Recommendations for diagnosis are still in transition and the role of NAATs has not been clearly defined.
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