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Evaluation of Methods for Detection of Clostridium difficile and its Toxins in Patients with Nosocomial Diarrhoea

Author(s): N. Sadeghifard | M.H. Salari | M.R. Ghasemi | F. Amin-Harati

Journal: Pakistan Journal of Biological Sciences
ISSN 1028-8880

Volume: 8;
Issue: 9;
Start page: 1256;
Date: 2005;
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Keywords: Clostridium difficile | stool cytotoxin assay | enzyme immunoassay | toxigenic culture

The aim of this study was to compare stool cytotoxin assay as the standard test with enzyme immunoassay system (C. difficile Tox A/B Tech Lab) and C. difficile bacterial culture on cycloserine-cefoxitin fructose agar followed by cytotoxin assay (toxigenic culture). A total of 650 stool specimens from hospitalized patients with nosocomial diarrhoea were collected from December 2002 to February 2004. C. difficile was detected by culture method in 146 samples. Of these samples 103 isolates were toxigenic by toxigenic culture. One hundred twelve and 108 stool specimens were positive for C. difficile toxins by enzyme immunoassay (Tox A/B immunoassay) and stool cytotoxin assay, respectively. Ninety eight samples were diagnosed to be positive in all test methods. Toxigenic C. difficile was isolated from 2 stool cytotoxin assay and 3 enzyme immunoassay negative stools. Sensitivity and specificity for Tox A/B immunoassay in relation to the stool cytotoxin assay was 95.6% (95% CI) and 98.3% (95% CI), respectively. The results of the present study showed that sensitivity and specificity Tox A/B immunoassay was very close with stool cytotoxin assay.
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