Evaluation of a Rapid Membrane Enzyme Immunoassay for the Simultaneous Detection of Glutamate Dehydrogenase and Toxin for the Diagnosis of Clostridium difficile Infection
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We evaluated the new C. DIFF QUIK CHEK COMPLETE (CD COMPLETE; TechLab, USA), which is a rapid membrane enzyme immunoassay that uses a combination of glutamate dehydrogenase (GDH) antigen and toxin A and B detection. A total of 608 consecutive loose stool specimens collected from the patients with suspected Clostridium difficile infec- tion (CDI) from August to December 2012 were subjected to the CD COMPLETE and VIDAS Clostridium difficile A & B (VIDAS CDAB; bioMérieux, France). Their performances were compared with a toxigenic culture as a reference. Stool specimens that were culture-nega- tive and CD COMPLETE- or VIDAS CDAB-positive were analyzed by using an enrichment procedure. In comparison to the toxigenic cultures, sensitivity, specificity, positive predictive values (PPV), and negative predictive values (NPV) were 63.6%, 98.0%, 76.1%, and 96.4%, respectively, for the CD COMPLETE-toxin and 75.5%, 97.4%, 72.5%, and 97.8%, respectively, for the VIDAS CDAB. In comparison to the enriched C. difficile cultures, the sensitivity, specificity, PPV, and NPV for the CD COMPLETE-GDH were 91.0%, 92.4%, 70.5%, and 98.1%, respectively. The CD COMPLETE is a reliable method for the diagnosis of CDI and provides greater sensitivity than toxin enzyme immunoassay alone. Furthermore, the CD COMPLETE-GDH has advantages over direct culture in detecting C. difficile.
Abstract
We evaluated the new C. DIFF QUIK CHEK COMPLETE (CD COMPLETE; TechLab, USA), which is a rapid membrane enzyme immunoassay that uses a combination of glutamate dehydrogenase (GDH) antigen and toxin A and B detection. A total of 608 consecutive loose stool specimens collected from the patients with suspected Clostridium difficile infec- tion (CDI) from August to December 2012 were subjected to the CD COMPLETE and VIDAS Clostridium difficile A & B (VIDAS CDAB; bioMérieux, France). Their performances were compared with a toxigenic culture as a reference. Stool specimens that were culture-nega- tive and CD COMPLETE- or VIDAS CDAB-positive were analyzed by using an enrichment procedure. In comparison to the toxigenic cultures, sensitivity, specificity, positive predictive values (PPV), and negative predictive values (NPV) were 63.6%, 98.0%, 76.1%, and 96.4%, respectively, for the CD COMPLETE-toxin and 75.5%, 97.4%, 72.5%, and 97.8%, respectively, for the VIDAS CDAB. In comparison to the enriched C. difficile cultures, the sensitivity, specificity, PPV, and NPV for the CD COMPLETE-GDH were 91.0%, 92.4%, 70.5%, and 98.1%, respectively. The CD COMPLETE is a reliable method for the diagnosis of CDI and provides greater sensitivity than toxin enzyme immunoassay alone. Furthermore, the CD COMPLETE-GDH has advantages over direct culture in detecting C. difficile.
참고문헌 (20)
- Kelly CP, "Clostridium difficile-more difficult than ever", N Engl J Med, 359, pp.1932~1940 (2008)
- Ticehurst JR, "Effective detection of toxigenic Clostridium difficile by a two-step algorithm including tests for antigen and cytotoxin", J Clin Microbiol, 44, pp.1145~1149 (2006)
- Eastwood K, "Comparison of nine commercially available Clostridium difficile toxin detection assays, a real-time PCR assay for C. difficile tcdB, and a glutamate dehydrogenase detection assay to cytotoxin testing and cytotoxigenic culture methods", J Clin Microbiol, 47, pp.3211~3217 (2009)
- Culbreath K, "Gilligan PH. Evolution of testing algorithms at a university hospital for detection of Clostridium infections", J Clin Microbiol, 50, pp.3073~3076 (2012)
- Bauer MP, "European Society of Clinical Microbiology and Infectious Diseases. European Society of Clinical Microbiology and Infectious Diseases (ESCMID): treatment guidance document for Clostridium difficile infection (CDI)", Clin Microbiol Infect, 15, pp.1067~1079 (2009)
- Bruins MJ, "Bruijnesteijn van Coppenraet LE, Kuijper EJ, Bloembergen P. Evaluation of three enzyme immunoassays and a loop-mediated isothermal amplification test for the laboratory diagnosis of Clostridium difficile infection", Eur J Clin Microbiol Infect Dis, 31, pp.3035~3039 (2012)
- Swindells J, "Evaluation of diagnostic tests for Clostridium difficile infection", J Clin Microbiol, 48, pp.606~608 (2010)
- Crobach MJ, "European Society of Clinical Microbiology and Infectious Diseases (ESCMID): data review and recommendations for diagnosing Clostridium difficile-infection (CDI)", Clin Microbiol Infect, 15, pp.1053~1066 (2009)
- Surawicz CM, "Guidelines for diagnosis, treatment, and prevention of Clostridium difficile infections", Am J Gastroenterol, 108, pp.478~498 (2013)
- Terhes G, "Community-acquired Clostridium difficile diarrhea caused by binary toxin, toxin A, and toxin B gene-positive isolates in Hungary", J Clin Microbiol, 42, pp.4316~4318 (2004)
- Spigaglia P, "Comparative analysis of Clostridium difficile clinical isolates belonging to different genetic lineages and time periods", J Med Microbiol, 53, pp.1129~1136 (2004)
- O’Neill GL, "Modification of a PCR ribotyping method for application as a routine typing scheme for Clostridium difficile", Anaerobe, 2, pp.205~209 (1996)
- Barbut F, "Rapid diagnosis of Clostridium difficile infection by multiplex real-time PCR", Eur J Clin Microbiol Infect Dis, 30, pp.1279~1285 (2011)
- Kim H, "Detection of Clostridium difficile toxin A", B genes by multiplex real-time PCR for the diagnosis of C. difficile infection, 2012, pp.61, 274~277
- Arroyo LG, "Use of a selective enrichment broth to recover Clostridium difficile from stool swabs stored under different conditions", J Clin Microbiol, 43, pp.5341~5343 (2005)
- Reller ME, "Yield of stool culture with isolate toxin testing versus a two-step algorithm including stool toxin testing for detection of toxigenic Clostridium difficile", J Clin Microbiol, 45, pp.3601~3605 (2007)
- Shetty N, "The role of glutamate dehydrogenase for the detection of Clostridium difficile in faecal samples: a meta-analysis", J Hosp Infect, 77, pp.1~6 (2011)
- Karre T, "Comparison of two commercial molecular assays to a laboratory-developed molecular assay for diagnosis of Clostridium difficile infection", J Clin Microbiol, 49, pp.725~727 (2011)
- Tenover FC, "Impact of strain type on detection of toxigenic Clostridium difficile: comparison of molecular diagnostic and enzyme immunoassay approaches", J Clin Microbiol, 48, pp.3719~3724 (2010)
- Goldenberg SD, "Lack of effect of strain type on detection of toxigenic Clostridium difficile by glutamate dehydrogenase and polymerase chain reaction", Diagn Microbiol Infect Dis, 70, pp.417~419 (2011)