Detection of Clostridium difficile in Feces of Asymptomatic Patients Admitted to the Hospital
| Autor: | Ed J. Kuijper, Margreet C. Vos, Monique J. T. Crobach, Elisabeth M. Terveer, Ingrid M J G Sanders, Cees M. Verduin |
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| Přispěvatelé: | Medical Microbiology & Infectious Diseases |
| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Microbiology (medical) Bacterial Toxins 030106 microbiology Clostridium difficile toxin A Polymerase Chain Reaction Sensitivity and Specificity Asymptomatic Microbiology Enterotoxins Feces 03 medical and health sciences Bacterial Proteins carrier Predictive Value of Tests diagnostics Humans asymptomatic Medicine Immunoassay Bacteriological Techniques Clostridioides difficile business.industry Bacteriology Clostridium difficile Gold standard (test) Predictive value Hospitals Carrier State Clostridium Infections medicine.symptom business FIRST screening test |
| Zdroj: | Journal of Clinical Microbiology, 55(2), 403-411. American Society for Microbiology Journal of Clinical Microbiology, 55(2), 403-411 |
| ISSN: | 1098-660X 0095-1137 |
| DOI: | 10.1128/jcm.01858-16 |
| Popis: | Recent evidence shows that patients asymptomatically colonized with Clostridium difficile may contribute to the transmission of C. difficile in health care facilities. Additionally, these patients may have a higher risk of developing C. difficile infection. The aim of this study was to compare a commercially available PCR directed to both toxin A and B ( artus C. difficile QS-RGQ kit CE; Qiagen), an enzyme-linked fluorescent assay to glutamate dehydrogenase (GDH ELFA) (Vidas, bioMérieux), and an in-house-developed PCR to tcdB , with (toxigenic) culture of C. difficile as the gold standard to detect asymptomatic colonization. Test performances were evaluated in a collection of 765 stool samples obtained from asymptomatic patients at admission to the hospital. The C. difficile prevalence in this collection was 5.1%, and 3.1% contained toxigenic C. difficile . Compared to C. difficile culture, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the C. difficile GDH ELFA were 87.2%, 91.2%, 34.7%, and 99.3%, respectively. Compared with results of toxigenic culture, the sensitivity, specificity, PPV, and NPV of the commercially available PCR and the in-house PCR were 95.8%, 93.4%, 31.9%, 99.9%, and 87.5%, 98.8%, 70%, and 99.6%, respectively. We conclude that in a low-prevalence setting of asymptomatically colonized patients, both GDH ELFA and a nucleic acid amplification test can be applied as a first screening test, as they both display a high NPV. However, the low PPV of the tests hinders the use of these assays as stand-alone tests. |
| Databáze: | OpenAIRE |
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