Comparison of two rapid assays for Clostridium difficile Common antigen and a C difficile toxin A/B assay with the cell culture neutralization assay

Am J Clin Pathol. 2010 Jan;133(1):107-9. doi: 10.1309/AJCPO3QWOU8CYGEU.

Abstract

We compared 3 rapid assays for Clostridium difficile with a cell culture cytotoxicity neutralization assay (CCNA). Of 600 stool samples, 46 were positive for toxigenic C difficile. Both rapid common antigen assays were highly sensitive (91.3%-100%) and, therefore, were appropriate screening tests. The rapid toxin assay had poor sensitivity (61%) but excellent specificity (99.3%). Testing stools for glutamate dehydrogenase (step 1) and those positive with a rapid toxin assay (step 2) would correctly classify 81% of submitted specimens within 2 hours, including during periods of limited staffing (evenings, nights, and weekends). CCNA could then be used as a third step to test rapid toxin-negative samples, thereby providing a final result for the remaining 19% of samples by 48 to 72 hours. The use of rapid assays as outlined could enhance timely diagnosis of C difficile.

Publication types

  • Comparative Study

MeSH terms

  • Antigens, Bacterial / analysis*
  • Bacterial Proteins / analysis*
  • Bacterial Proteins / immunology
  • Bacterial Toxins / analysis*
  • Bacterial Toxins / immunology
  • Bacteriological Techniques / methods*
  • Cells, Cultured
  • Clostridioides difficile / isolation & purification*
  • Enterotoxins / analysis*
  • Enterotoxins / immunology
  • Feces / enzymology
  • Feces / microbiology*
  • Fibroblasts / cytology
  • Fibroblasts / microbiology
  • Foreskin / cytology
  • Foreskin / microbiology
  • Glutamate Dehydrogenase / analysis
  • Glutamate Dehydrogenase / metabolism
  • Humans
  • Male
  • Neutralization Tests / methods
  • Predictive Value of Tests

Substances

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