title: A two-stage algorithm for Clostridium difficile including PCR: can we replace the toxin EIA?
abstract: A two step, three-test algorithm for Clostridium difficile infection (CDI) was reviewed. Stool samples were tested by enzyme immunoassays for C. difficile common antigen glutamate dehydrogenase (G) and toxin A/B (T). Samples with discordant results were tested by polymerase chain reaction detecting the toxin B gene (P). The algorithm quickly identified patients with detectable toxin A/B, whereas a large group of patients excreting toxigenic C. difficile but with toxin A/B production below detection level (G(+)T(-)P(+)) was identified separately. The average white blood cell count in patients with a G(+)T(+) result was higher than in those with a G(+)T(-)P(+) result.
authors: University Hospital of North Staffordshire NHS Trust, Stoke-on-Trent, UK. j.orendi@doctors.net
authors: J M
authors: JM
authors: Orendi
authors: D J
authors: DJ
authors: Monnery
authors: S
authors: S
authors: Manzoor
authors: P M
authors: PM
authors: Hawkey
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D000942:Antigens, Bacterial / Q000032:analysis; D001427:Bacterial Toxins / Q000032:analysis* / Q000235:genetics*; D002648:Child; D002675:Child, Preschool; D019411:Clinical Laboratory Techniques / Q000379:methods*; D016360:Clostridioides difficile / Q000235:genetics* / Q000302:isolation & purification; D003015:Clostridium Infections / Q000175:diagnosis* / Q000382:microbiology; D005243:Feces / Q000737:chemistry / Q000382:microbiology; D006801:Humans; D007124:Immunoenzyme Techniques / Q000379:methods; D016133:Polymerase Chain Reaction / Q000379:methods*
chemical_list: D000942:Antigens, Bacterial; D001427:Bacterial Toxins