Absence of Toxemia in Clostridioides difficile Infection: Results from Ultrasensitive Toxin Assay of Serum.
Absence of Toxemia in Clostridioides difficile Infection: Results from Ultrasensitive Toxin Assay of Serum.
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DOI：
10.1007/s10620-020-06683-8
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发表时间：
2021-10
影响因子：
3.1
通讯作者：
Kelly CP
中科院分区：
文献类型：
--
作者：
Sprague R;Warny K;Pollock N;Daugherty K;Lin Q;Xu H;Cuddemi C;Barrett C;Chen X;Banz A;Lantz A;Garey KW;Gonzales-Luna AJ;Alonso CD;Galvez JAV;Kelly CP
艰难梭菌感染 (CDI) 由艰难梭菌致病菌株分泌的毒素 A 和 B 引起。这种感染的症状严重程度和临床表现差异很大。目前用于诊断 CDI 的检测可能缺乏检测血液中循环的外毒素所需的灵敏度。超灵敏单分子阵列 (Simoa) 测定法经过修改，可分别检测血清中的毒素 A 和毒素 B，检测限为低皮克水平。当应用于不同的队列时，Simoa 无法检测到 CDI 患者血清中的毒素 A 或 B，其中包括许多被归类为患有严重疾病的患者。毒素的检测可能受到血清中循环的抗毒素抗体的推断的限制。这一结果不支持艰难梭菌感染发生毒血症的假设，与其他已发表报告的结果相矛盾。
Clostridioides difficile infection (CDI) is caused by Toxins A and B, secreted from pathogenic strains of C.difficle. This infection can vary greatly in symptom severity and in clinical presentation. Current assays used to diagnose CDI may lack the required sensitivity to detect the exotoxins circulating in blood. The ultrasensitive Single Molecule Array (Simoa) assay was modified to separately detect toxin A and toxin B in serum with a limit of detection at the low picogram level. When applied to a diverse cohort, Simoa was unable to detect Toxin A or B in serum from patients with CDI, including many classified as having severe disease. The detection of toxin may be limited by the inferenece of anti-toxin anti-bodies circulating in serum. This result does not support the hypothesis that toxemia occurs in C. difficile infection, conflicting with the findings of other published reports.
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DOI：
10.1056/nejmoa1910215
发表时间：
2020-04-02
期刊：
The New England journal of medicine
影响因子：
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影响因子：
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