Evaluation of Rapid Assay (Tox A/B Quik Chek) for the Detection of Clostridium difficile Toxins A and B
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배경: Clostridium difficile 연관 설사의 빠른 진단을 위해 독소 면역시험이 널리 사용되고 있다. 본 연구에서는 Tox A/B Quik Chek (TECHLAB, Blacksburg, VA, USA)으로 시험한 결과를 독소생성 C. difficile 배양 결과와 비교하여 그 유용성을 평가하고자 하였다. 방법: 2006년 9월부터 2007년 8월까지 959개의 변 검체로 시행한 Tox A/B Quik Chek 시험과 독소생성 C. difficile 배양 (변 검체를 선택배지에 접종하고, 증식된 집락으로 tcdB PCR을 시행) 결과를 비교 분석하였다. 결과: 독소생성 C. difficile 배양 결과를 근거로 하였을 때, Tox A/B Quik Chek 시험의 민감도와 특이도는 각각 47.5%와 97.5%이었다. 결론: Tox A/B Quik Chek 시험은 민감도는 높지 않았으나 특이도는 높아서, 이를 단독으로 진단에 이용하기에는 충분하 지 않을 수 있으나, 세균 배양, 독소시험 등과 병행 사용하면 환자의 조기진단, 치료, 원내감염의 전파방지에 도움이 될 수 있을 것으로 생각된다.
Abstract
Background: Toxin immunoassay is widely used for rapid diagnosis of Clostridium difficile-associated diarrhea. The aim of this study was to evaluate the performance of Tox A/B Quik Chek test (TECHLAB, Blacksburg, VA, USA) compared to toxigenic culture. Methods: From September 2006 to August 2007, 959 stools were examined by Tox A/B Quik Chek test and toxigenic culture (C. difficile culture plus tcdB PCR using colonies obtained from culture). Results: Compared to the results of toxigenic culture, the sensitivity and specificity of Tox A/B Quik Chek test were 47.5% and 97.5%, respectively. Conclusion: The sensitivity of Tox A/B Quik Chek test was not high, but the specificity was high. Although Tox A/B Quik Chek test alone is not sufficient to diagnose Clostridium difficile-associated diarrhea, it may aid rapid diagnosis, early treatment and prevention of nosocomial spread of the infection, if supplemented by C. difficile culture or tissue culture cytotoxin assay.
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