Clinical and laboratory evaluation of a real-time PCR for Clostridium difficile toxin A and B genes.

European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology
E de JongP D J Sturm

Abstract

Many laboratories use enzyme immunoassays (EIAs) for the diagnosis of Clostridium difficile infection (CDI). More recently, polymerase chain reaction (PCR)-based diagnosis has been described as a sensitive test. Real-time PCR for the detection of C. difficile toxin A and B genes was evaluated. A prospective evaluation was performed on stool samples from 150 hospitalized adult patients and 141 healthy volunteers. PCR was compared to toxigenic culture (TC), direct cytotoxicity test (CTT), ImmunoCard® Toxin A and B (Meridian Bioscience), and enzyme-linked immunosorbent assay (ELISA) (Vidas). The results were correlated with clinical data using a standardized questionnaire. The diagnostic yield of the PCR was further evaluated after implementation. Using toxigenic culture as the gold standard, the sensitivity and specificity of PCR were 100 and 99.2%, respectively. Patients were categorized as follows: TC/PCR-positive (n = 17) and negative TC (n = 133). The differences in these groups were more frequent use of antibiotics and leukocytosis (p < 0.05). The diagnostic yield of PCR was evaluated during a period of 6 months and showed an increase of positive patients by 50%. PCR for the detection of toxigenic C. difficile has a high sen...Continue Reading

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Citations

Aug 1, 2013·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Carolyn V GouldUNKNOWN Clostridium difficile Infection Surveillance Investigators, Centers for Disease Control and Prevention
Sep 27, 2012·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Yves LongtinJean Longtin
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Methods Mentioned

BETA
PCR
enzyme-linked immunosorbent assay
ELISA
biopsies

Software Mentioned

ICTAB

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