Superiority of the DNA amplification assay for the diagnosis of C. difficile infection: a clinical comparison of fecal tests.

Digestive Diseases and Sciences
Jodie A BarkinDaniel A Sussman

Abstract

Clostridium difficile infection (CDI) is a major infectious concern, accounting for substantial morbidity and resource utilization. Advances in microbiological and molecular techniques have resulted in an increasing number of testing options for CDI. A glutamate dehydrogenase (GDH) enzyme immunoassay (EIA) and a DNA amplification (DNA-A) test for the diagnosis of CDI have recently become commercially available. The aim of this prospective study was to compare the test performance characteristics of the traditional diagnostic modality for CDI diagnosis, the toxin A/B (TOX) EIA, with those of the GDH EIA and DNA-A test, utilizing enriched toxigenic culture (TGC) as the gold standard. Clinical variables predictive of CDI were also studied. Participants fulfilled one or more criteria placing them at increased risk for CDI. Each stool sample was tested by each of the methods mentioned above. Clinical data parameters were collected via a 12-month review of the electronic medical record prior to the index date of the first stool test. A total of 272 stool samples from 144 admissions of 139 patients were evaluated for CDI. The sensitivity and positive predictive value (PPV) of the TOX EIA were 86.1 and 58.4 %, respectively, whereas the...Continue Reading

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Jun 15, 2013·Current Problems in Surgery·J D StanleyJ H Ashcraft
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Jan 24, 2020·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·Erik Hans VogelzangRobin van Houdt

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