title: Two-stage algorithm for Clostridium difficile: glutamate-dehydrogenase-positive toxin-negative enzyme immunoassay results may require further testing.
abstract: This study investigated 102 episodes in which a glutamate dehydrogenase-positive enzyme immunoassay (EIA)-toxin-negative result was obtained with a C. difficile testing protocol. Of these 102 stool samples, 46% were culture positive with a toxigenic strain and nine were followed by an EIA-toxin-positive result within 2-32 days. The data accord with our policy of keeping these patients in side-rooms until asymptomatic and of encouraging treatment of those with otherwise unexplained persistent diarrhoea. Adding a third testing modality [toxigenic culture or polymerase chain reaction (PCR)] appears desirable but there may be significant differences in sensitivity between different toxigenic culture or PCR methods.
authors: Department of Microbiology, Sunderland Royal Hospital, Sunderland, UK. Giuseppe.Bignardi@chsft.nhs.uk
authors: G E
authors: GE
authors: Bignardi
authors: K
authors: K
authors: Hill
authors: A
authors: A
authors: Berrington
authors: C D
authors: CD
authors: Settle
mesh_terms: D000465:Algorithms; D001427:Bacterial Toxins / Q000032:analysis*; D001431:Bacteriological Techniques / Q000379:methods*; D016360:Clostridioides difficile / Q000302:isolation & purification*; D003015:Clostridium Infections / Q000175:diagnosis* / Q000382:microbiology; D005243:Feces / Q000382:microbiology; D005969:Glutamate Dehydrogenase / Q000032:analysis*; D006801:Humans; D007124:Immunoenzyme Techniques / Q000379:methods; D012680:Sensitivity and Specificity
chemical_list: D001427:Bacterial Toxins; D005969:Glutamate Dehydrogenase