Abstract
We evaluated a two-step algorithm for detecting toxigenic Clostridium difficile: an enzyme immunoassay for glutamate dehydrogenase antigen (Ag-EIA) and then, for antigen-positive specimens, a concurrent cell culture cytotoxicity neutralization assay (CCNA). Antigen-negative results were > or = 99% predictive of CCNA negativity. Because the Ag-EIA reduced cell culture workload by approximately 75 to 80% and two-step testing was complete in < or = 3 days, we decided that this algorithm would be effective. Over 6 months, our laboratories' expenses were US dollar 143,000 less than if CCNA alone had been performed on all 5,887 specimens.
Publication types
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Comparative Study
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Evaluation Study
MeSH terms
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Algorithms
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Antigens, Bacterial / analysis
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Bacteriological Techniques / economics
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Bacteriological Techniques / methods*
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Bacteriological Techniques / statistics & numerical data
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Clostridioides difficile / enzymology
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Clostridioides difficile / immunology
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Clostridioides difficile / isolation & purification*
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Clostridioides difficile / pathogenicity
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Costs and Cost Analysis
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Cytotoxins / analysis
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Enterocolitis, Pseudomembranous / diagnosis
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Glutamate Dehydrogenase / immunology
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Humans
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Immunoenzyme Techniques / economics
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Immunoenzyme Techniques / methods
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Immunoenzyme Techniques / statistics & numerical data
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Neutralization Tests
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Sensitivity and Specificity
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Software Design
Substances
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Antigens, Bacterial
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Cytotoxins
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Glutamate Dehydrogenase