To the Editor We read with interest the recent article in JAMA Internal Medicine by Polage et al,1 who report on the outcomes of Clostridium difficile infection (CDI), using a laboratory diagnostic strategy of either combined toxin enzyme immunoassay and polymerase chain reaction (PCR) assay results or on the basis of the PCR assay result alone. Their conclusion was that patients with only a positive PCR (PCR+) result had outcomes similar to patients without C difficile infection and that exclusive reliance on molecular tests for CDI diagnosis is likely to result in overdiagnosis and overtreatment.
Moloney G, O'Connell B, Rogers TR. Toxin Immunoassays and Clostridium difficile Infection. JAMA Intern Med. 2016;176(3):413-414. doi:10.1001/jamainternmed.2015.8536