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Evaluation of methods for detection of toxins in specimens of feces submitted for diagnosis of clostridium difficile- associated diarrhea
O'Connor, D.; Hynes, P.; Cormican, M.; Collins, E.; Corbett-Feeney, G.; Cassidy, M.
Clostridium difficile is the principal pathogen associated with hospital-acquired acute diarrheal disease. We have evaluated the performances of six approaches for diagnosis of C. difficile-associated diarrhea (CDAD). Consecutive stool specimens (n = 200) from 133 patients were examined by cytotoxin assay, by culture of C. difficile on cycloserine-cefoxitin-fructose agar, and by toxin detection using four rapid immunoassay systems (Oxoid Toxin A test, ImmunoCard Toxin A test, TechLab Tox A/B II test, and Premier Toxins A&B test). A diagnosis of CDAD was established for 35 (27%) patients (representing 29% of specimens). The adjusted sensitivity and specificity of the methods were, respectively, 98 and 99% for the cytotoxin assay, 54 and 99% for ImmunoCard, 50 and 98% for Oxoid, 79 and 98% for TechLab, 80 and 98% for Premier, and 57 and 100% for culture. The TechLab and Premier assays are acceptable tests for diagnosis of CDAD but are not equivalent to the cytotoxin assay.
Keyword(s): multicenter evaluation; cytotoxicity assay; a/b test; culture; colitis; infection; stools; strain
Publication Date:
2018
Type: Journal article
Peer-Reviewed: Unknown
Institution: NUI Galway
Publisher(s): American Society for Microbiology
First Indexed: 2019-03-23 06:51:21 Last Updated: 2019-03-23 06:51:21