Comparative Evaluation of Luminex xTAG® Gastrointestinal Pathogen Panel and Direct-From-Stool Real-Time PCR for Detection of C. difficile Toxin tcdB in Stool Samples from a Pediatric Population

Hannah Tyrrell; Sarah B N Morin; Colin D Lloyd; Brendon Parsons; Taryn Stokowski; Jianling Xie; Ran Zhuo; Bonita E Lee; Xiao-Li Pang; Stephen B Freedman; Linda Chui

doi:10.3390/microorganisms10112214

Comparative Evaluation of Luminex xTAG^® Gastrointestinal Pathogen Panel and Direct-From-Stool Real-Time PCR for Detection of C. difficile Toxin tcdB in Stool Samples from a Pediatric Population

Microorganisms. 2022 Nov 9;10(11):2214. doi: 10.3390/microorganisms10112214.

Authors

Hannah Tyrrell¹, Sarah B N Morin¹, Colin D Lloyd¹, Brendon Parsons¹, Taryn Stokowski¹, Jianling Xie², Ran Zhuo¹, Bonita E Lee³, Xiao-Li Pang^{1

4}, Stephen B Freedman⁵, Linda Chui^{1

4}

Affiliations

¹ Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB T6G 1C9, Canada.
² Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB T3B 6A8, Canada.
³ Department of Pediatrics, Women and Children's Health Research Institute, University of Alberta, Edmonton, AB T6G 1C9, Canada.
⁴ Alberta Precision Laboratories: Public Health Laboratory, Edmonton, AB T6G 2J2, Canada.
⁵ Sections of Pediatric Emergency Medicine and Gastroenterology, Departments of Pediatrics and Emergency Medicine, Alberta Children's Hospital Research Institute, Alberta Children's Hospital, Cumming School of Medicine, University of Calgary, Calgary, AB T3B 6A8, Canada.

Abstract

Detection of Clostridioides difficile toxins in patients with gastroenteritis has increasingly been accomplished through the use of enteric multiplex syndromic panels. Comparisons of the performance of these panels to both direct-from-stool (DFS) and culture-enriched stools followed by polymerase chain reaction (PCR) methods in pediatric populations are limited. Here, we compare the performance of the Luminex xTAG^® Gastrointestinal Pathogen Panel (GPP) to our DFS in-house real-time PCR (DFS RT-PCR) assay for the detection of C. difficile toxin gene, tcdB, using 2641 stool specimens collected from children enrolled in the Alberta Provincial Pediatric EnTeric Infection Team (APPETITE) study in Alberta, Canada. We used culture enrichment followed by in-house RT-PCR to resolve discordant results between the two assays. We found excellent agreement (k = 0.89) between the GPP and our DFS RT-PCR assay: the positive percent agreement between the two assays was 97%, and the negative percent agreement was 99%. GPP, a multi-analyte platform can easily be implemented into a routine diagnostic laboratory for detecting enteric pathogens including C. difficile.

Keywords: C. difficile; Luminex xTAG® GPP; children; culture; real-time PCR; stool.

Grants and funding

Not available/Alberta Innovates