A two-step approach improves the diagnosis of Clostridium difficile infection

J Microbiol Methods. 2017 Dec:143:17-19. doi: 10.1016/j.mimet.2017.09.015. Epub 2017 Sep 29.

Abstract

Clostridium difficile infection (CDI) is a major cause of health care-associated diarrhea. The aim of the present study was to evaluate a two-step approach for the diagnosis of CDI. The two-step procedure consisted of GDH-toxin A/B EIA (Enzyme immunoassay targeting enterotoxin A and Cytotoxin B), followed by PCR detecting toxigenic C. difficile. Results indicate that EIAs provide a rapid screening assay for the laboratory diagnosis of CDI but, in GDH-positive and toxins-negative samples, EIA should be always followed by PCR to distinguish toxigenic vs nontoxigenic strains. GDH-toxin A/B EIA-rapid test has high specificity but low sensitivity to detect CDI. The implementation of a two-step procedure significantly increases the diagnostic accuracy to detect CDI and provides a toxigenic type characterization of C. difficile isolates.

Keywords: C. difficile; Infection; PCR; Toxin genes; Two-step diagnostic procedure.

Publication types

  • Evaluation Study

MeSH terms

  • Bacterial Proteins / analysis
  • Bacterial Toxins / analysis
  • Clostridium Infections / diagnosis*
  • DNA, Bacterial / analysis
  • Enterotoxins / analysis
  • Glutamate Dehydrogenase / analysis
  • Humans
  • Immunoenzyme Techniques / methods*
  • Polymerase Chain Reaction / methods*
  • Sensitivity and Specificity

Substances

  • Bacterial Proteins
  • Bacterial Toxins
  • DNA, Bacterial
  • Enterotoxins
  • tcdA protein, Clostridium difficile
  • toxB protein, Clostridium difficile
  • Glutamate Dehydrogenase