title: Evaluation of a commercial real-time polymerase chain reaction assay for detection of environmental contamination with Clostridium difficile.
abstract: Contaminated environmental surfaces are an important source for transmission of Clostridium difficile. However, there are no efficient and easy methods to assess contamination. The performance of a commercial real-time polymerase chain reaction (PCR) assay was evaluated for detection of environmental toxigenic C. difficile in comparison with anaerobic culture followed by toxin testing of isolates. For 66 sites sampled, PCR had a sensitivity of 17.39%, specificity 100%, positive predictive value 100% and negative predictive value 69.35%. Increasing the PCR cycle threshold (CT) value to 45 increased sensitivity to 52% without decreasing specificity. The commercial PCR assay is not sufficiently sensitive for environmental monitoring, but improved sensitivity might be possible through CT value modification.
authors.affiliation: Department of Medicine, Division of Infectious Diseases, Case Western Reserve University, Cleveland, OH, USA. abhishekdp@gmail.com
authors.forename: A
authors.initials: A
authors.lastname: Deshpande
authors.forename: S
authors.initials: S
authors.lastname: Kundrapu
authors.forename: V C K
authors.initials: VC
authors.lastname: Sunkesula
authors.forename: J L
authors.initials: JL
authors.lastname: Cadnum
authors.forename: D
authors.initials: D
authors.lastname: Fertelli
authors.forename: C J
authors.initials: CJ
authors.lastname: Donskey
mesh_terms: D001431:Bacteriological Techniques / Q000379:methods*; D016360:Clostridioides difficile / Q000302:isolation & purification*; D004783:Environmental Microbiology; D006801:Humans; D011446:Prospective Studies; D060888:Real-Time Polymerase Chain Reaction / Q000379:methods*; D012680:Sensitivity and Specificity
keywords: Clostridium difficile; Environmental contamination; Polymerase chain reaction