title: Evaluation of the Alere SHIGA TOXIN QUIK CHEK™ in comparison to multiplex Shiga toxin PCR.
abstract: Shiga toxin-producing Escherichia coli (STEC) causes gastrointestinal outbreaks worldwide and due to its low infectious dose highly sensitive diagnostics are needed. In this study, the performance of the enzyme immunoassay SHIGA TOXIN QUIK CHEK (STQC) (Alere, TechLab) for the detection of Stx1 and Stx2 was evaluated directly from fecal samples, from culture on agar (SMAC(-CT)) and from broth enrichment (mTSB) in comparison to our in-house multiplex PCR. The STQC could not detect the Stx2f subtype, but detected all other subtypes with an analytical sensitivity varying between 10(8) and 10(4) CFU/ml. The SMAC(-CT) assay had the best performance with an overall sensitivity of 93.3%; broth and direct fecal testing had sensitivities of 74.1% and only 46.7%, respectively. All methods were 100% specific. Because of the unacceptably low sensitivity we do not recommend applying the STQC directly on stools, but only after overnight culture.
authors.affiliation: National Reference Centre for STEC/VTEC, Department of Microbiology and Infection Control, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB) Brussels, Laarbeeklaan 101, 1090, Brussels, Belgium. Electronic address: klara.derauw@uzbrussel.be.
authors.forename: Klara
authors.initials: K
authors.lastname: De Rauw
authors.affiliation: National Reference Centre for STEC/VTEC, Department of Microbiology and Infection Control, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB) Brussels, Laarbeeklaan 101, 1090, Brussels, Belgium.
authors.forename: Johan
authors.initials: J
authors.lastname: Breynaert
authors.affiliation: National Reference Centre for STEC/VTEC, Department of Microbiology and Infection Control, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB) Brussels, Laarbeeklaan 101, 1090, Brussels, Belgium.
authors.forename: Denis
authors.initials: D
authors.lastname: Piérard
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods*; D004927:Escherichia coli Infections / Q000175:diagnosis*; D005243:Feces / Q000382:microbiology*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction / Q000379:methods*; D012680:Sensitivity and Specificity; D022621:Shiga Toxin / Q000032:analysis*; D054323:Shiga-Toxigenic Escherichia coli / Q000302:isolation & purification*
chemical_list: D022621:Shiga Toxin
keywords: Alere SHIGA TOXIN QUIK CHEK™; Enzyme immunoassay; Shiga toxin-producing Escherichia coli