title: Comparison of eight commercial enzyme immunoassays for the detection of Clostridium difficile from stool samples and effect of strain type.
abstract: We compared the performance of 8 Clostridium difficile enzyme immunoassays to cell cytotoxicity neutralization assay and toxigenic culture. The effect of strain type on assay performance was also examined. There were a total of 71 (14.4%) samples in which C. difficile was recovered; 58 (81.7%) of 71 were toxigenic. Compared to a composite reference standard of either C. difficile cytotoxin assay positive or toxigenic C. difficile culture positive, the sensitivities of these assays varied from 31.7% to 55.2%, while the specificities were excellent, ranging from 98.1% to 100%. Among the 57 C. difficile isolates, 30 (51.7%) were of the NAP1 genotype. Stool samples positive for the C. difficile NAP1 strain had a higher positivity rate for the toxin assays.
authors.affiliation: McGill University Health Centre, McGill University, Montréal, Québec, Canada. pierre.rene@muhc.mcgill.ca
authors.forename: Pierre
authors.initials: P
authors.lastname: René
authors.forename: Charles P
authors.initials: CP
authors.lastname: Frenette
authors.forename: Ian
authors.initials: I
authors.lastname: Schiller
authors.forename: Nandini
authors.initials: N
authors.lastname: Dendukuri
authors.forename: Paul
authors.initials: P
authors.lastname: Brassard
authors.forename: Susan
authors.initials: S
authors.lastname: Fenn
authors.forename: Vivian G
authors.initials: VG
authors.lastname: Loo
mesh_terms: D001427:Bacterial Toxins / Q000032:analysis* / Q000633:toxicity; D001431:Bacteriological Techniques / Q000379:methods*; D018929:Cell Culture Techniques / Q000379:methods; D002470:Cell Survival; D016360:Clostridioides difficile / Q000145:classification / Q000302:isolation & purification* / Q000472:pathogenicity; D003015:Clostridium Infections / Q000175:diagnosis / Q000382:microbiology*; D005243:Feces / Q000737:chemistry / Q000382:microbiology*; D006801:Humans; D007124:Immunoenzyme Techniques / Q000379:methods; D012680:Sensitivity and Specificity
chemical_list: D001427:Bacterial Toxins