Simultaneous Detection of Clostridioides difficile Glutamate Dehydrogenase and Toxin A/B: Comparison of the C. DIFF QUIK CHEK COMPLETE and RIDASCREEN Assays

Various commercial assays have recently been developed for detecting glutamate dehydrogenase (GDH) and/or toxin A/B to diagnose Clostridioides difficile infection (CDI). We compared the performance of two assays for the simultaneous detection of C. difficile GDH and toxin A/B, using 150 stool samples: C. DIFF QUIK CHEK COMPLETE (QCC; TechLab, Blacksburg, VA, USA) and RIDASCREEN Clostridium difficile GDH (RC-GDH) and Toxin A/B (RC-Toxin A/B; R-Biopharm, Darmstadt, Germany). For GDH detection, QCC and RC-GDH showed satisfactory sensitivity (95.7% and 94.3%, respectively) and specificity (92.5% and 93.8%, respectively) compared with C. difficile culture. For toxin A/B detection, QCC showed higher sensitivity than RC-Toxin A/B (60.0% vs 33.3%, P < 0.001) compared with toxigenic C. difficile culture. When the results of QCC or RC-GDH+RC-Toxin A/B were used as the first step of a two-step algorithm for diagnosing CDI, QCC permitted more accurate discrimination than RC of positive or negative results for CDI (77.3% and 65.3%, respectively). QCC is useful for the simultaneous detection of C. difficile GDH and toxin A/B as a part of the two-step algorithm for diagnosing CDI.

CLINICAL APPLICATION OF CLOSTRIDIUM DIFFICILE TOXIN A/B DETECTION IN THE OUTSIDE HOSPITAL AND NOSOCOMIAL INFECTION IN TAISHAN AREA / 现代医院

Objective To investigate the application of Clostridium difficile toxin A/B detection on the out-side hospital and nosocomial infection in Taishan area .Methods The stool samples of 528 diarrhea patients newly admitted from May 2013 to October 2014 were collected as the outside hospital suspicious group , and the patients were aged 8 to 75 years old, including 249 males and 279 females.Relatively, the stool samples of 523 patients hos-pitalized more than a week and treated with antibiotics more than 3 days were collected as the nosocomial suspicious group, and the patients aged 7 to 74 years, 209 males and 314 females.Clostridium difficile toxin A/B was detected, and the comprehensive statistical analysis combined with thebacterial culture results , clinical diagnosis and curative effect was made .Results The clostridium difficile infection rate outside the hospital was 4% and the infection rate in hospital after using antibiotics was 16%.By Clostridium difficile toxin A/B detection , the positive rate of outside hospital infection was 85%, and that of nosocomial infection was 90%.Conclusion The Clostridium difficile toxin A/B detection is worthy of clinical application for its rapid and accurate outside hospital and nosocomial infection de -tection in Taishan area .