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Journal of Clinical Microbiology, May 2001, p. 1996-1998, Vol. 39, No. 5
0095-1137/01/$04.00+0   DOI: 10.1128/JCM.39.5.1996-1998.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.

Laboratory Diagnosis of Clostridium difficile-Associated Diarrhea and Colitis: Usefulness of Premier Cytoclone A+B Enzyme Immunoassay for Combined Detection of Stool Toxins and Toxigenic C. difficile Strains

Alain Lozniewski,1 Christian Rabaud,2 Emmanuelle Dotto,1 Michele Weber,1 and Francine Mory1,*

Laboratoire de Bactériologie, Hôpital Central, Centre Hospitalier et Universitaire, 54035 Nancy Cedex,1 and Service de Maladies Infectieuses et Tropicales, Hôpital de Brabois, Centre Hospitalier et Universitaire, 54500 Vandoeuvre,2 France

Received 27 October 2000/Returned for modification 20 December 2000/Accepted 5 February 2001

Detection of Clostridium difficile toxins A and B in stools by Premier Cytoclone A+B enzyme immunoassay (EIA) was compared with detection by stool culture for C. difficile followed by detection of toxigenic isolates using the same EIA. Chart reviews were performed to evaluate the likelihood of C. difficile-associated diarrhea and colitis (CADC) for all patients with at least one positive toxin assay. While the toxins were detected in 58 of 85 consecutive CADC patients by both assays, CADC in 5 patients was detected only by stool toxin assay, and in 22 patients CADC was detected only by toxigenic culture. Our results suggest that for laboratories using a rapid toxin A+B EIA, direct toxin detection in stools should be combined with toxigenic culture in cases in which there is a negative stool toxin assay.

* Corresponding author. Mailing address: Laboratoire de Bactériologie, Hôpital Central, 29, Avenue du Maréchal de Lattre de Tassigny, 54035 Nancy Cedex, France. Phone: (33) 3-83-85-14-34. Fax: (33) 3-83-85-26-73. E-mail: f.mory{at}chu-nancy.fr.

Journal of Clinical Microbiology, May 2001, p. 1996-1998, Vol. 39, No. 5
0095-1137/01/$04.00+0   DOI: 10.1128/JCM.39.5.1996-1998.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.


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