Evaluation of an enzyme immunoassay for detection ofClostridium difficile toxin A

1992 ◽  
Vol 11 (6) ◽  
pp. 563-564 ◽  
Author(s):  
K. Tsimidis ◽  
A. E. Simor
Keyword(s):  
Enzyme Immunoassay ◽  
Toxin A ◽  
Ofclostridium Difficile

scholarly journals Comparison of Culture, Cytotoxin Assay and Two Eia Tests with Clinical Diagnosis ofClostridium difficile-Associated Diarrhea

1994 ◽  
Vol 5 (4) ◽  
pp. 163-167 ◽  
Author(s):  
Marilyn Binning ◽  
Michael A John ◽  
Berend C Schieven ◽  
Thomas W Austin ◽  
Robert Lannigan ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Selective Medium ◽  
Infectious Diarrhea ◽  
Toxin A ◽  
Ofclostridium Difficile ◽  
Clinical Criteria ◽  
Hospital Patients ◽  
Common Etiology ◽  
Stool Specimens ◽  
Single Laboratory

Objective: The most common etiology of infectious diarrhea in hospitalized patients isClostridium difficile. No single laboratory test yields a definitive diagnosis. Four methods were evaluated for their sensitivity and specificity in patients who had clinically definedC difficile-associated diarrhea.Methods: Clinical criteria forC difficile-associated diarrhea were defined. All adult in-hospital patients whose stools were tested forC difficilewere prospectively followed. Stools were examined with culture on a selective medium, a commercial cytotoxicity assay (cta), and two commercially available enzyme immunoassays (eias) for toxin A (Meridian) and toxin AB (cbc).Results: During the study period 235 stool specimens from 185 patients were tested. Fifty-one patients were positive forC difficileor its markers,ctawas most sensitive (80%), whereascbc-eiawas most specific (98%). Differences in the sensitivities ofctaand Meridian-eiawere minor (80% versus 73.3%) and they were equally specific (95.5%).Conclusions: The sensitivity and specificity ofeiafor toxin A is similar to other tests. However, due to rapidity and ease of performance, it may be a more practical test for the diagnosis ofC difficile-associated diarrhea, especially if the cytotoxin assay is not available.

On the mode of action ofClostridium difficile toxin A: anin vitro study

1991 ◽  
Vol 5 (S1) ◽  
pp. 84-85 ◽  
Author(s):  
C. Fiorentini ◽  
G. Donelli ◽  
P. Nicotera ◽  
P. Mastrantonio ◽  
M. Thelestam
Keyword(s):  
Mode Of Action ◽  
Vitro Study ◽  
Toxin A ◽  
Ofclostridium Difficile

Cloning of the carbohydrate-binding portion of the toxin A gene ofClostridium difficile

1987 ◽  
Vol 16 (1) ◽  
pp. 55-60 ◽  
Author(s):  
Stuart B. Price ◽  
Carol J. Phelps ◽  
Tracy D. Wilkins ◽  
John L. Johnson
Keyword(s):  
Carbohydrate Binding ◽  
Toxin A ◽  
Ofclostridium Difficile

scholarly journals Evaluation of Two Rapid Assays for Detection ofClostridium difficile Toxin A in Stool Specimens

1999 ◽  
Vol 37 (9) ◽  
pp. 3044-3047 ◽  
Author(s):  
Daniel P. Fedorko ◽  
Howard D. Engler ◽  
Elizabeth M. O’Shaughnessy ◽  
Esther C. Williams ◽  
Cynthia J. Reichelderfer ◽  
...  
Keyword(s):  
Predictive Value ◽  
Chart Review ◽  
Laboratory Diagnosis ◽  
Clinical Diagnostics ◽  
Becton Dickinson ◽  
Toxin A ◽  
Ofclostridium Difficile ◽  
Rapid Assays ◽  
Toxigenic Culture ◽  
Stool Specimens

Rapid laboratory diagnosis of Clostridium difficile-associated diarrhea (CDAD) is highly desirable in the setting of hospital cost containment. We tested 654 stool specimens to compare the performance of two assays for rapid detection of toxin A, the Immunocard Toxin A test (Meridian Diagnostics, Inc.) and the Culturette Brand Toxin CD enzyme immunoassay (EIA) (Becton Dickinson Microbiology Systems), with a cytotoxin assay (Cytotoxi Test; Advanced Clinical Diagnostics) and culture on cycloserine-cefoxitin-fructose agar followed by determination of the production of toxins A and B. A chart review was performed for patients whose stool specimens provided positive results on one to three of the assays. With the “gold standard” of all four assays positive or chart review evidence of CDAD, 97 (14.8%) stool specimens were positive by one or more assays and 557 (85.2%) were negative by all methods. Total agreement for all assays was 90.5% (592 of 654). The sensitivity, specificity, positive predictive value, and negative predictive value for toxigenic culture were 94.7, 98.6, 87.1, and 99.5%, respectively, for toxigenic culture; 87.7, 98.6, 86.2, and 98.8%, respectively, for the cytotoxin assay; 71.9, 99.3, 91.1, and 97.3%, respectively, for the Immunocard; and 68.4, 99.1, 88.6, and 96.9%, respectively, for the Culturette EIA. While easy to perform and highly specific, these rapid assays do not appear to be sufficient for accurate diagnosis of CDAD.

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