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Closteridium Difficile GDH

Bacterial/ Viral
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Report in 4Hrs

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Screens for GDH enzyme of C. difficile.

₹2,738₹3,911

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Clostridium Difficile GDH Test Information Guide

  • Why is it done?
    • Detects glutamate dehydrogenase (GDH) enzyme produced by Clostridium difficile bacteria in stool samples
    • Screens for C. difficile colonization or infection in patients with diarrhea or suspected antibiotic-associated colitis
    • Used as an initial screening test due to its high sensitivity for detecting C. difficile organisms in stool
    • Ordered when patients present with watery diarrhea, abdominal cramping, and fever following antibiotic use
    • Performed in hospitalized patients or those in long-term care facilities experiencing infectious diarrhea
    • May be used for treatment follow-up to monitor clearance of infection
  • Normal Range
    • Normal Result: Negative or Absent - No GDH enzyme detected in stool sample
    • Abnormal Result: Positive or Present - GDH enzyme detected in stool, indicating C. difficile organisms present
    • Test Methodology: Typically reported as positive/negative or reactive/non-reactive
    • Units: Qualitative (Positive/Negative) - enzyme immunoassay (EIA) or molecular assay based on method
    • Interpretation: Negative indicates absence of C. difficile; Positive suggests presence of organism (may indicate colonization or active disease)
  • Interpretation
    • Positive GDH Result: Indicates C. difficile organisms are present in the stool; does not differentiate between toxigenic (disease-causing) and non-toxigenic strains
    • Negative GDH Result: Suggests C. difficile infection is unlikely; good negative predictive value (>95%)
    • Clinical Correlation Required: GDH positivity alone does not confirm C. difficile disease; patient symptoms, risk factors, and other test results must be considered
    • High Sensitivity, Lower Specificity: GDH test detects all C. difficile (sensitivity 90-99%) but cannot distinguish toxin-producing strains from non-pathogenic colonizers
    • Factors Affecting Results: Recent antibiotic use, immunosuppression, previous C. difficile infection, age >65 years, and severity of diarrhea affect likelihood of positive results
    • Serial Testing: Repeat testing of same patient within 7 days is not recommended; GDH may remain positive during treatment or after symptom resolution
  • Associated Organs
    • Primary Target Organ: Colon and large intestine; C. difficile colonizes and produces toxins in the lower gastrointestinal tract
    • Associated Conditions: Antibiotic-associated diarrhea, pseudomembranous colitis, C. difficile infection (CDI), fulminant colitis, toxic megacolon
    • Common Risk Factors: Antibiotic therapy (especially fluoroquinolones, cephalosporins, clindamycin), hospitalization, immunosuppression, advanced age, proton pump inhibitor use
    • Potential Complications: Severe dehydration, electrolyte imbalances, acute kidney injury, sepsis, colonic perforation, toxic megacolon, recurrent infection
    • Gastrointestinal System Impact: Inflammation of colon lining, pseudomembrane formation, loss of intestinal barrier integrity, disruption of normal gut flora
    • Systemic Effects: Severe cases may lead to sepsis, involving multiple organ systems and requiring intensive care management
  • Follow-up Tests
    • Toxin A and Toxin B Testing: Recommended for positive GDH results to confirm disease-causing toxigenic strains; typically performed reflexively
    • NAAT (Nucleic Acid Amplification Test): PCR testing may be ordered for higher specificity or to detect toxigenic C. difficile strains like ribotype 027
    • Complete Blood Count (CBC): Assess for leukocytosis, anemia, and thrombocytopenia indicating severity of infection
    • Comprehensive Metabolic Panel (CMP): Evaluate electrolytes, renal function, liver function, and assess for dehydration complications
    • Lactate Level: Elevated lactate may indicate severe infection, fulminant disease, or sepsis
    • Abdominal Imaging (CT or Ultrasound): Ordered if severe colitis or complications suspected; may show colonic wall thickening, megacolon
    • Colonoscopy: May be performed in severe or fulminant cases to visualize pseudomembranes or rule out other conditions
    • Procalcitonin or CRP: Assess severity of inflammation and systemic response; elevated levels indicate more severe disease
    • Repeat Testing: Not recommended within 7 days of initial test; test of cure is not indicated for routine CDI
  • Fasting Required?
    • Fasting Required: No - This is a stool sample test; no fasting is necessary
    • Sample Collection: Fresh stool sample collected in a sterile container; liquid or unformed stool preferred
    • Sample Timing: Collect sample as soon as symptoms appear; preferably within first 48 hours of diarrhea onset
    • Medication Restrictions: No restrictions for test collection; however, avoid antiperistaltic agents (loperamide, diphenoxylate) as these may increase toxin absorption and worsen disease
    • Preparation Instructions: Collect stool in clean, dry container provided by laboratory; at least 5-10 mL of sample needed for accurate testing
    • Transportation: Transport sample to laboratory within 2 hours of collection; refrigeration may be needed if delay expected; do not freeze sample
    • Test Specifics: Avoid contamination with urine, water, or toilet paper; do not mix sample with preservatives unless instructed by laboratory

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