Evaluation of Methods for Detection of Toxins in Specimens of Feces Submitted for Diagnosis of Clostridium difficile- Associated Diarrhea
Evaluation of Methods for Detection of Toxins in Specimens of Feces Submitted for Diagnosis of Clostridium difficile- Associated Diarrhea
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用于诊断艰难梭菌相关腹泻的粪便样本中毒素检测方法的评价
DOI：
10.1128/jcm.39.8.2846-2849.2001
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发表时间：
2001
影响因子：
9.4
通讯作者：
M. Cassidy
中科院分区：
文献类型：
--
作者：
Don O’Connor;Pearl Hynes;M. Cormican;Edward Collins;G. Corbett;M. Cassidy
艰难梭菌是医院获得性急性腹泻的主要病原菌。我们已经评估了六种诊断C。艰难梭菌相关性腹泻（CDAD）。对133例患者的200份粪便标本进行了细胞毒素检测、C.艰难梭菌在环丝氨酸-头孢西丁-果糖琼脂上的毒素检测，以及使用四种快速免疫测定系统（Oxoid毒素A测试、ImmunoCard毒素A测试、TechLab Tox A/B II测试和Premier毒素A&B测试）的毒素检测。35例（27%）患者（占标本的29%）确诊为CDAD。调整后的方法的灵敏度和特异性分别为：细胞毒素测定法98%和99%，ImmunoCard法54%和99%，Oxoid法50%和98%，TechLab法79%和98%，Premier法80%和98%，培养法57%和100%。TechLab和Premier检测试剂盒是诊断CDAD的可接受检测试剂盒，但不等同于细胞毒素检测试剂盒。
ABSTRACT Clostridium difficile is the principal pathogen associated with hospital-acquired acute diarrheal disease. We have evaluated the performances of six approaches for diagnosis of C. difficile-associated diarrhea (CDAD). Consecutive stool specimens (n = 200) from 133 patients were examined by cytotoxin assay, by culture of C. difficile on cycloserine-cefoxitin-fructose agar, and by toxin detection using four rapid immunoassay systems (Oxoid Toxin A test, ImmunoCard Toxin A test, TechLab Tox A/B II test, and Premier Toxins A&B test). A diagnosis of CDAD was established for 35 (27%) patients (representing 29% of specimens). The adjusted sensitivity and specificity of the methods were, respectively, 98 and 99% for the cytotoxin assay, 54 and 99% for ImmunoCard, 50 and 98% for Oxoid, 79 and 98% for TechLab, 80 and 98% for Premier, and 57 and 100% for culture. The TechLab and Premier assays are acceptable tests for diagnosis of CDAD but are not equivalent to the cytotoxin assay.