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Comparison of four methods in the diagnosis ofClostridium difficile disease

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Abstract

Nine hundred forty-five stool specimens from patients suspected of havingClostridium difficile disease were examined using a cell culture cytotoxicity assay (CTA), two enzyme immunoassay (EIA) kits (Cytoclone for toxins A and B; VIDAS for toxin A) and a latex agglutination assay (CDT). One hundred nineteen specimens had positive titers (≥90) in the CTA; clinical review of 16 discordant samples and 49 controls supported the significance of 90 as the positive cut-off titer. The performance of the two EIAs and the latex assay was assessed relative to CTA titers of the samples. Sensitivity was ≤ 50 % for all three assays for the 24 specimens with CTA titers of 90, but it reached 97–100 % for the two EIAs and 84 % for the latex assay at titers of ≥ 2,250. The Cytoclone EIA exhibited higher sensitivity at the lower positive titers. Overall, specificity of the methods ranged from 96.7 % (CDT latex assay) to 99.1 % (Cytoclone EIA).

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Authors and Affiliations

  1. Clinical Microbiology Laboratories — Gray 5, Massachusetts General Hospital, 02114, Boston, Massachusetts, USA

    A. R. Mattia, J. Holden & M. J. Ferraro

  2. Harvard Medical School, Boston, Massachusetts, USA

    A. R. Mattia & M. J. Ferraro

  3. University of Massachusetts Medical Center, Worcester, Massachusetts, USA

    G. V. Doern, J. Clark & L. Wu

Authors
  1. A. R. Mattia
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  2. G. V. Doern
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  3. J. Clark
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  4. J. Holden
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  5. L. Wu
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  6. M. J. Ferraro
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Mattia, A.R., Doern, G.V., Clark, J. et al. Comparison of four methods in the diagnosis ofClostridium difficile disease. Eur. J. Clin. Microbiol. Infect. Dis. 12, 882–886 (1993). https://doi.org/10.1007/BF02000416

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  • DOI: https://doi.org/10.1007/BF02000416

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