title: Rapid detection of Clostridium difficile toxin A in stool specimens.
abstract: OBJECTIVE: To evaluate a rapid (15-min) enzyme immunoassay in the format of an individual cassette (ImmunoCard toxin A, Meridian, BMD, Marne-la-Vallée, France) for the detection of Clostridium difficile toxin A in stool specimens. METHODS: We compared this new test with the cytotoxicity assay using MRC-5 cells, the ToxA test (TechLab, BioWhittaker, Fontenay-sous-bois, France) and toxigenic culture for the diagnosis of C. difficile-associated diseases (CDAD). A total of 236 stool specimens collected from 220 patients was simultaneously tested with the four methods. Discordant results were resolved by reviewing patients' clinical records. RESULTS: The prevalence of CDAD was 13.9%. Test sensitivities and specificities were 100% and 99% respectively for the cytotoxicity assay, 87.5% and 100% for ImmunoCard toxin A, 77.4% and 100% for the ToxA test and 100% and 98% for toxigenic culture. CONCLUSIONS: The ImmunoCard Toxin A is a very rapid, individual and easy-to-perform test for the diagnosis of CDAD. It provides same-day results and may be useful for both guiding appropriate treatment and controlling nosocomial spread of C. difficile.
authors.affiliation: Service de Bactériologie-Virologie et.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Barbut
authors.forename: Muriel
authors.initials: M
authors.lastname: Macé
authors.forename: Valérie
authors.initials: V
authors.lastname: Lalande
authors.forename: Patrick
authors.initials: P
authors.lastname: Tilleul
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Petit