Clostridia in OAT vs CDSA
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Dr. Woeller,
I had the understanding that if clostridia showed up high (3+ or 4+) on the CDSA, we still cannot say it is a problem without looking at the OAT, which would confirm a problem if 4-cresol or HPHPA are high.
However, I had a case a while back where the CDSA was suspicious enough that GPL (Doctors Data) ran a DNA test and determined the presence of Toxins A and B, confirming toxic C-Diff. However, this patient also did an OAT at the same time that showed near 0 levels of 4-cresol (and normal HPHPA). If they had not run the DNA secondary test (which I did not ask for) this would have been missed. Because of this, I have less confidence to say that the OAT can confirm or rule out C-Diff. Your thoughts on this, does 4- cresol not always show up with c-diff? Is perhaps the GI-Map a better alternative? Thank you.
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