title: [Selection of Laboratory Procedures to Detect Toxigenic by the 2-Step Method].
abstract: The 2-step method is an algorithm to detect toxigenicClostridium difficile. We herein compared the sensitivities and specificities of an enzyme immunoassay (toxin A/B-EIA), toxigenic culture (TC-EIA), Loop-Mediated Isothermal Amplification assay (LAMP), and XpertC. difficile(Xpert) with the detection of the toxin B gene by a polymerase chain reaction (PCR). The results obtained showed that the sensitivities and specificities of toxin A/B-EIA, Xpert, TC-EIA, and LAMP were 30 and 100%, 87.2 and 100%, 97.5 and 89.7%, and 95 and 100%, respectively. We also evaluated the turnaround time (TAT) and cost of toxigenicC. difficiledetection. Our hospital TAT for toxin A/B-EIA and TC-EIA are 37 min and 5 days, respectively. We estimated the TAT of Xpert, LAMP, and PCR to be 105 min, 5 days, and 6 days, respectively. On the other hand, the cost to detect toxigenicC. difficileincreased in the order of TC-EIA, LAMP, Xpert, and PCR. We have never experienced outbreak ofClostridium difficileinfection (CDI) in our hospital, and there is less the number of CDI than other place. So we selected TC-EIA that is good sensitivity and low cost per specimen. Hereafter it'll be necessary to solve a problem it takes time, because we have to respond to outbreak of CDI quickly if it happens.
authors.affiliation: Department of Clinical Laboratory, University Hospital, Kyoto Prefectural University of Medicine.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Tanino
authors.affiliation: Department of Infection Control and Laboratory Medicine, Kyoto Prefectural University of Medicine.
authors.forename: Mai
authors.initials: M
authors.lastname: Kodama
authors.affiliation: Department of Clinical Laboratory, University Hospital, Kyoto Prefectural University of Medicine.
authors.forename: Hiroomi
authors.initials: H
authors.lastname: Daicho
authors.affiliation: Department of Clinical Laboratory, University Hospital, Kyoto Prefectural University of Medicine.
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Miyauchi
authors.affiliation: Department of Clinical Laboratory, University Hospital, Kyoto Prefectural University of Medicine.
authors.forename: Towa
authors.initials: T
authors.lastname: Yasumoto
authors.affiliation: Department of Clinical Laboratory, University Hospital, Kyoto Prefectural University of Medicine.
authors.forename: Yukiji
authors.initials: Y
authors.lastname: Yamada
authors.affiliation: Department of Clinical Laboratory, University Hospital, Kyoto Prefectural University of Medicine.
authors.forename: Noriko
authors.initials: N
authors.lastname: Kyotani
authors.affiliation: Department of Clinical Laboratory, University Hospital, Kyoto Prefectural University of Medicine.
authors.forename: Satoko
authors.initials: S
authors.lastname: Kurahashi
authors.affiliation: Department of Clinical Laboratory, University Hospital, Kyoto Prefectural University of Medicine.
authors.forename: Masaji
authors.initials: M
authors.lastname: Ushiyama
authors.affiliation: Department of Clinical Laboratory, University Hospital, Kyoto Prefectural University of Medicine.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kimura
authors.affiliation: Department of Clinical Laboratory, University Hospital, Kyoto Prefectural University of Medicine.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Komori
authors.affiliation: Department of Infection Control and Laboratory Medicine, Kyoto Prefectural University of Medicine.
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Fujitomo
authors.affiliation: Department of Infection Control and Laboratory Medicine, Kyoto Prefectural University of Medicine.
authors.forename: Masaki
authors.initials: M
authors.lastname: Nakanishi
authors.affiliation: Department of Infection Control and Laboratory Medicine, Kyoto Prefectural University of Medicine.
authors.forename: Naohisa
authors.initials: N
authors.lastname: Fujita
mesh_terms: D001431:Bacteriological Techniques / Q000191:economics / Q000379:methods*; D016360:Clostridioides difficile / Q000235:genetics / Q000302:isolation & purification*; D007124:Immunoenzyme Techniques / Q000191:economics / Q000379:methods*; D016133:Polymerase Chain Reaction / Q000191:economics / Q000379:methods*; D013997:Time Factors