Evaluation of Diagnostic Tests for Clostridium difficile Infection

ABSTRACT We evaluated toxigenic Clostridium difficile detection by a lateral flow assay for antigen and toxin, an enzyme immunoassay, and two commercial PCR methods. Compared to the cell cytotoxicity neutralization assay and toxigenic culture, both toxin detection methods lacked sensitivity. PCR following combined antigen and toxin detection provided the most useful diagnostic information.

[1]  E. Baron,et al.  Laboratory diagnosis of Clostridium difficile infection can molecular amplification methods move us out of uncertainty? , 2011, The Journal of molecular diagnostics : JMD.

[2]  N. Shetty,et al.  Laboratory diagnosis of Clostridium difficile infection. An evaluation of tests for faecal toxin, glutamate dehydrogenase, lactoferrin and toxigenic culture in the diagnostic laboratory , 2009, British journal of biomedical science.

[3]  K. Carroll,et al.  Comparison of a Commercial Real-Time PCR Assay for tcdB Detection to a Cell Culture Cytotoxicity Assay and Toxigenic Culture for Direct Detection of Toxin-Producing Clostridium difficile in Clinical Samples , 2008, Journal of Clinical Microbiology.

[4]  Richard Holliman,et al.  Diagnosis of Clostridium difficile infection by toxin detection kits: a systematic review. , 2008, The Lancet. Infectious diseases.

[5]  E. Kuijper,et al.  Decreased effectiveness of metronidazole for the treatment of Clostridium difficile infection? , 2008, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[6]  P. Gilligan Is a Two-Step Glutamate Dehyrogenase Antigen-Cytotoxicity Neutralization Assay Algorithm Superior to the Premier Toxin A and B Enzyme Immunoassay for Laboratory Detection of Clostridium difficile? , 2008, Journal of Clinical Microbiology.

[7]  A. Widmer,et al.  Rapid and Reliable Diagnostic Algorithm for Detection of Clostridium difficile , 2007, Journal of Clinical Microbiology.

[8]  K. Carroll,et al.  Yield of Stool Culture with Isolate Toxin Testing versus a Two-Step Algorithm Including Stool Toxin Testing for Detection of Toxigenic Clostridium difficile , 2007, Journal of Clinical Microbiology.

[9]  E. Kuijper,et al.  Evaluation of real-time PCR and conventional diagnostic methods for the detection of Clostridium difficile-associated diarrhoea in a prospective multicentre study. , 2007, Journal of medical microbiology.

[10]  K. Carroll,et al.  Effective Detection of Toxigenic Clostridium difficile by a Two-Step Algorithm Including Tests for Antigen and Cytotoxin , 2006, Journal of Clinical Microbiology.

[11]  M. Delmée,et al.  Laboratory diagnosis of Clostridium difficile-associated diarrhoea: a plea for culture. , 2005, Journal of medical microbiology.

[12]  Michael A. John,et al.  Performance of the TechLab C. DIFF CHEK-60 Enzyme Immunoassay (EIA) in Combination with the C. difficile Tox A/B II EIA Kit, the Triage C. difficile Panel Immunoassay, and a Cytotoxin Assay for Diagnosis of Clostridium difficile-Associated Diarrhea , 2004, Journal of Clinical Microbiology.

[13]  M. Delmée,et al.  A European survey of diagnostic methods and testing protocols for Clostridium difficile. , 2003, Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases.

[14]  T. Wilkins,et al.  Clostridium difficile Testing: after 20 Years, Still Challenging , 2003, Journal of Clinical Microbiology.

[15]  J. Brazier,et al.  PCR Targeted to the 16S-23S rRNA Gene Intergenic Spacer Region ofClostridium difficile and Construction of a Library Consisting of 116 Different PCR Ribotypes , 1999, Journal of Clinical Microbiology.