Faris S Alnezary¹, Masaad Saeed Almutairi² , Rasil O Alsuwaylim², Lubna M Albolwi¹, Manar H Alrehaili¹, Fahad Alzahrani¹, Mansour Mahmoud¹, Amanj Kurdi^3-6, Brian Godman^3,6,7, Omar A Almohammed⁸, Abrar K Thabit⁹

¹Department of Pharmacy Practice, College of Pharmacy, Taibah University, Madinah 41477; ²Department of Pharmacy Practice, College of Pharmacy, Qassim University, Qassim 51452, Saudi Arabia; ³Strathclyde Institute of Pharmacy and Biomedical Sciences, Strathclyde University, Glasgow, UK; ⁴Department of Clinical Pharmacy, College of Pharmacy, Hawler Medical University, Kurdistan Regional Governorate, Erbil; ⁵Department of Clinical Pharmacy, College of Pharmacy, Al-Kitab University, Kirkuk, 36015, Iraq; ⁶Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria 0204, South Africa; ⁷Antibiotic Policy Group, Institute for Infection and Immunity, City St. George’s, University of London, London SW17 0RE, United Kingdom; ⁸Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh; ⁹Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia.

For correspondence:-  Masaad Almutairi   Email: mas.almutairi@qu.edu.sa

Received: 15 March 2025        Accepted: 19 May 2025        Published: 31 May 2025

Citation: Alnezary FS, Almutairi MS, Alsuwaylim RO, Albolwi LM, Alrehaili MH, Alzahrani F, et al. A survey on Clostridioides difficile infection (CDI) testing in microbiology laboratories in Saudi Arabia: Findings and implications. Trop J Pharm Res 2025; 24(5):731-738 doi: https://dx.doi.org/10.4314/tjpr.v24i5.11

© 2025 The authors.
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Abstract

Purpose: To investigate various critical elements of Clostridioides difficile infection (CDI) testing in laboratories in Saudi Arabia, encompassing diagnostic techniques employed, testing protocols, specimen handling procedures, result reporting practices, and resource availability.

Method: A cross-sectional study was conducted via an online survey to assess CDI testing protocols and procedures employed by microbiologists in Saudi Arabia. The questionnaire examined various aspects of testing procedures, laboratory protocols, testing schedules, and obstacles to conducting CDI tests. Differences were compared using Chi-square. P < 0.05 was considered significant.

Results: The survey elicited responses from 68 hospitals across 13 administrative regions of Saudi Arabia. A total of 52.9 % (n = 36) came from small hospitals (≤ 200 beds), distributed across 8 regions. The Western region contained the highest number of responding hospitals overall (44.1 %, n = 30). There was significant difference in positive CDI tests reported between large hospitals (> 200 beds; 59.4 %, n = 19) and small hospitals (13.9 %, n = 5; p < 0.001). Among laboratories that test in-house, 22.7 % (n = 15) reported using nucleic acid amplification tests, 25.8 % (n = 17) reported sending stool specimens to external laboratories, 11.8 % (n = 8) reported using multistep methods, and 25.8 % (n = 17) were unsure of the used tests. Limited institutional budget for CDI testing kits was the most commonly reported barrier by laboratory microbiologists.

Conclusion: While CDI testing practices in Saudi Arabian microbiology laboratories generally align with international guidelines, this survey identifies opportunities for improvement through enhanced education, implementation of evidence-based testing algorithms, and addressing resource limitations

Keywords: Clostridioides difficile, Clostridium difficile, Microbiology, Laboratory technique, Saudi Arabia

Impact Factor
Thompson Reuters (ISI): 0.6 (2023)
H-5 index (Google Scholar): 49 (2023)