A two-stage algorithm for Clostridium difficile including PCR: can we replace the toxin EIA?

J Hosp Infect. 2012 Jan;80(1):82-4. doi: 10.1016/j.jhin.2011.09.012. Epub 2011 Nov 21.

Abstract

A two step, three-test algorithm for Clostridium difficile infection (CDI) was reviewed. Stool samples were tested by enzyme immunoassays for C. difficile common antigen glutamate dehydrogenase (G) and toxin A/B (T). Samples with discordant results were tested by polymerase chain reaction detecting the toxin B gene (P). The algorithm quickly identified patients with detectable toxin A/B, whereas a large group of patients excreting toxigenic C. difficile but with toxin A/B production below detection level (G(+)T(-)P(+)) was identified separately. The average white blood cell count in patients with a G(+)T(+) result was higher than in those with a G(+)T(-)P(+) result.

Publication types

  • Evaluation Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Algorithms
  • Antigens, Bacterial / analysis
  • Bacterial Toxins / analysis*
  • Bacterial Toxins / genetics*
  • Child
  • Child, Preschool
  • Clinical Laboratory Techniques / methods*
  • Clostridioides difficile / genetics*
  • Clostridioides difficile / isolation & purification
  • Clostridium Infections / diagnosis*
  • Clostridium Infections / microbiology
  • Feces / chemistry
  • Feces / microbiology
  • Humans
  • Immunoenzyme Techniques / methods
  • Polymerase Chain Reaction / methods*

Substances

  • Antigens, Bacterial
  • Bacterial Toxins