title: Detection of Clostridium difficile cytotoxin and Clostridium perfringens enterotoxin in cases of diarrhoea in the community.
abstract: Faecal specimens from 843 cases of diarrhoea in the community were tested for the presence of Clostridium difficile cytotoxin and Clostridium perfringens enterotoxin. C. difficile cytotoxin was detected in faecal specimens from 0.6 % of cases aged at least 2 years by using a Vero cell assay. Factors associated with detection of C. difficile cytotoxin were antibiotic therapy, age over 60 years and living in a home with other elderly people. Three methods were used for the detection of C. perfringens enterotoxin: a Vero cell assay, a commercial (TechLab) enzyme immunoassay (EIA) and an in-house EIA. The lower level of detection of pure C. perfringens enterotoxin in buffer was 0.01 micro g ml(-1) by the TechLab EIA and 1.0 micro g ml(-1) by the Vero cell assay. C. perfringens enterotoxin was detected by using the TechLab EIA in faecal specimens from 2.5 % of cases. This commercial EIA was less sensitive than the in-house EIA, detecting only 31 % of positive cases, but was specific and could be used for outbreak investigation by routine diagnostic laboratories. Age over 60 years was a factor associated with C. perfringens enterotoxin detection; this age group may be targeted for testing.
authors.affiliation: Health Protection Agency, Yorkshire and the Humber Region, Leeds Laboratory, Bridle Path, Leeds LS15 7TR, UK 2Food Safety Microbiology Laboratory, 61 Colindale Avenue, London NW9 5HT, UK.
authors.forename: L J
authors.initials: LJ
authors.lastname: Forward
authors.affiliation: Health Protection Agency, Yorkshire and the Humber Region, Leeds Laboratory, Bridle Path, Leeds LS15 7TR, UK 2Food Safety Microbiology Laboratory, 61 Colindale Avenue, London NW9 5HT, UK.
authors.forename: D S
authors.initials: DS
authors.lastname: Tompkins
authors.affiliation: Health Protection Agency, Yorkshire and the Humber Region, Leeds Laboratory, Bridle Path, Leeds LS15 7TR, UK 2Food Safety Microbiology Laboratory, 61 Colindale Avenue, London NW9 5HT, UK.
authors.forename: M M
authors.initials: MM
authors.lastname: Brett
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D001426:Bacterial Proteins; D001427:Bacterial Toxins / Q000032:analysis*; D002648:Child; D002675:Child, Preschool; D002522:Chlorocebus aethiops; D016360:Clostridioides difficile / Q000378:metabolism*; D003015:Clostridium Infections / Q000453:epidemiology / Q000382:microbiology*; D003016:Clostridium perfringens / Q000378:metabolism*; D003967:Diarrhea / Q000453:epidemiology / Q000382:microbiology*; D004761:Enterocolitis, Pseudomembranous / Q000453:epidemiology / Q000382:microbiology; D004768:Enterotoxins / Q000032:analysis*; D005243:Feces / Q000737:chemistry*; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques / Q000379:methods; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D014709:Vero Cells
chemical_list: D001426:Bacterial Proteins; D001427:Bacterial Toxins; D004768:Enterotoxins; C035598:enterotoxin, Clostridium; C031815:toxB protein, Clostridium difficile