Overview of current detection methods and microRNA potential in Clostridioides difficile infection screening

Table 1 Summary of Clostridioides difficile diagnostic tests

Test	Abbreviation	Sensitivity	Specificity	Turn-around time	Target substance
Culture-based
Cell cytotoxicity neutralisation assay	CCTN	High	High	< 24 h	Toxins
Toxigenic culture	TC	High	Low1	> 3 d	C. difficile vegetative cells or spores
DNA-based
Nucleic acid amplification test2	NAAT	High	Low/moderate	< 4 h	Toxin genes
Protein-based
Glutamate dehydrogenase	GDH-EIA	High	Low1	< 2 h	C. difficile antigens
Toxin A and B enzyme immunoassays	EIA	Low	Moderate	< 2 h	Toxins

¹Nucleic acid amplification test, mainly using the PCR technique.

²Must be combined with a toxin test.

C. difficile: Clostridioides difficile; TC: Toxigenic culture; NAAT: Nucleic acid amplification test; CCTN: Cell cytotoxicity neutralisation assay; GDH: Glutamate dehydrogenase; EIA: Enzyme immunoassay.