Detection of toxigenic Clostridioides [Clostridium] difficile: Usefulness of two commercially available enzyme immunoassays and a PCR assay on stool samples and stool isolates
The best laboratory diagnostic approach to detect Clostridioides [Clostridium] difficile infection (CDI) is a subject of ongoing debate. With the aim of evaluating four laboratory diagnostic methods, 250 unformed stools from patients with suspected CDI submitted to nine medical center laboratories f...
| Autores principales: | , , , , , , , , , , , , , , , |
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| Formato: | Articulo |
| Lenguaje: | Inglés |
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2018
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| Acceso en línea: | http://sedici.unlp.edu.ar/handle/10915/96675 https://ri.conicet.gov.ar/11336/63581 https://www.sciencedirect.com/science/article/pii/S0325754117301098?via%3Dihub |
| Aporte de: |
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I19-R120-10915-96675 |
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| record_format |
dspace |
| institution |
Universidad Nacional de La Plata |
| institution_str |
I-19 |
| repository_str |
R-120 |
| collection |
SEDICI (UNLP) |
| language |
Inglés |
| topic |
Biología CDI diagnosis Clostridioides difficile Clostridium difficile |
| spellingShingle |
Biología CDI diagnosis Clostridioides difficile Clostridium difficile Legaria, María C. Rollet, Raquel Di Martino, Ana Castello, Liliana Barberis, Claudia Rossetti, María A. Guardati, María C. Fernández Canigia, Liliana Carloni, Graciela Herminia Litterio, Mirta Rocchi, Marta Anchart, Eduardo G. Trejo, Fernando Miguel Minnaard, Jessica Klajn, Diana Predari, Silvia C. Detection of toxigenic Clostridioides [Clostridium] difficile: Usefulness of two commercially available enzyme immunoassays and a PCR assay on stool samples and stool isolates |
| topic_facet |
Biología CDI diagnosis Clostridioides difficile Clostridium difficile |
| description |
The best laboratory diagnostic approach to detect Clostridioides [Clostridium] difficile infection (CDI) is a subject of ongoing debate. With the aim of evaluating four laboratory diagnostic methods, 250 unformed stools from patients with suspected CDI submitted to nine medical center laboratories from November 2010 to December 2011, were studied using: (1) an immunochromatographic rapid assay test that combines the qualitative determination of glutamate dehydrogenase (GDH) plus toxins A and B (QAB), the CDIFF QUIK CHEK COMPLETE assay; (2) an enzyme immunoassay for qualitative determination of toxins A and B, the RIDASCREEN™ C. difficile Toxin A/B assay (RAB); (3) a PCR for the toxin B gene assay (PCR); and (4) the toxigenic culture (TC). C. difficile isolates from direct toxin negative stools by QAB, RAB and PCR were evaluated for toxigenicity by the same direct tests, in order to assess the contribution of the TC (QAB-TC, RAB-TC, PCR-TC). A combination of the cell culture cytotoxicity neutralization assay (CCCNA) in stools, and the same assay on isolates from direct negative samples (CCCNA-TC) was considered the reference method (CCCNA/CCCNA-TC). Of the 250 stools tested, 107 (42.8%) were positive by CCCNA/CCCNA-TC. The GDH and PCR/PCR-TC assays were the most sensitive, 91.59% and 87.62%, respectively. The QAB, RAB, QAB/QAB-TC and RAB/RAB-TC had the highest specificities, ca. 95%. A negative GDH result would rule out CDI, however, its low positive likelihood ratio (PLR) of 3.97 indicates that a positive result should always be complemented with the detection of toxins. If the RAB, QAB, and PCR assays do not detect toxins from direct feces, the toxigenic culture should be performed. In view of our results, the most accurate and reliable methods to be applied in a clinical microbiology laboratory were the QAB/QAB-TC, and RAB/RAB-TC, with PLRs >10 and negative likelihood ratios <0.30. |
| format |
Articulo Articulo |
| author |
Legaria, María C. Rollet, Raquel Di Martino, Ana Castello, Liliana Barberis, Claudia Rossetti, María A. Guardati, María C. Fernández Canigia, Liliana Carloni, Graciela Herminia Litterio, Mirta Rocchi, Marta Anchart, Eduardo G. Trejo, Fernando Miguel Minnaard, Jessica Klajn, Diana Predari, Silvia C. |
| author_facet |
Legaria, María C. Rollet, Raquel Di Martino, Ana Castello, Liliana Barberis, Claudia Rossetti, María A. Guardati, María C. Fernández Canigia, Liliana Carloni, Graciela Herminia Litterio, Mirta Rocchi, Marta Anchart, Eduardo G. Trejo, Fernando Miguel Minnaard, Jessica Klajn, Diana Predari, Silvia C. |
| author_sort |
Legaria, María C. |
| title |
Detection of toxigenic Clostridioides [Clostridium] difficile: Usefulness of two commercially available enzyme immunoassays and a PCR assay on stool samples and stool isolates |
| title_short |
Detection of toxigenic Clostridioides [Clostridium] difficile: Usefulness of two commercially available enzyme immunoassays and a PCR assay on stool samples and stool isolates |
| title_full |
Detection of toxigenic Clostridioides [Clostridium] difficile: Usefulness of two commercially available enzyme immunoassays and a PCR assay on stool samples and stool isolates |
| title_fullStr |
Detection of toxigenic Clostridioides [Clostridium] difficile: Usefulness of two commercially available enzyme immunoassays and a PCR assay on stool samples and stool isolates |
| title_full_unstemmed |
Detection of toxigenic Clostridioides [Clostridium] difficile: Usefulness of two commercially available enzyme immunoassays and a PCR assay on stool samples and stool isolates |
| title_sort |
detection of toxigenic clostridioides [clostridium] difficile: usefulness of two commercially available enzyme immunoassays and a pcr assay on stool samples and stool isolates |
| publishDate |
2018 |
| url |
http://sedici.unlp.edu.ar/handle/10915/96675 https://ri.conicet.gov.ar/11336/63581 https://www.sciencedirect.com/science/article/pii/S0325754117301098?via%3Dihub |
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