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Journal of Clinical Microbiology, October 2004, p. 4863-4865, Vol. 42, No. 10
0095-1137/04/$08.00+0     DOI: 10.1128/JCM.42.10.4863-4865.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.

Performance of the TechLab C. DIFF CHEK-60 Enzyme Immunoassay (EIA) in Combination with the C. difficile Tox A/B II EIA Kit, the Triage C. difficile Panel Immunoassay, and a Cytotoxin Assay for Diagnosis of Clostridium difficile-Associated Diarrhea

Heather Snell,1 Meredith Ramos,1 Sue Longo,1 Michael John,1,2,3 and Zafar Hussain1,2,3*

Department of Clinical Microbiology and Infection Control, London Health Sciences Centre,1 Division of Medical Microbiology and Infectious Diseases,2 Department of Microbiology and Immunology, University of Western Ontario, London, Ontario, Canada3

Received 24 March 2004/ Returned for modification 31 May 2004/ Accepted 11 July 2004

We compared a recently marketed enzyme immunoassay for glutamate dehydrogenase (GDH), TechLab's C. DIFF CHEK-60 (TL-GDH), in combination with the C. difficile Tox A/B II enzyme immunoassay (Tox-A/B) with (i) the Triage C. difficile test, which detects both GDH (TR-GDH) and toxin A (TR-Tox-A); (ii) an in-house cytotoxin assay (C-Tox); and (iii) stool cultures for C. difficile. All C. difficile isolates were tested for the presence of the toxin genes by PCR. If a toxin gene-positive strain of Clostridium difficile was recovered and a toxin was detected by any method, the result was considered to be truly positive. Eighty-seven of 93 and 79 of 93 C. difficile culture-positive samples were also TL-GDH and TR-GDH positive, respectively. No test was able to detect toxin in all samples with true-positive results. Tox-A/B and TR-Tox-A in combination with the GDH detection tests and C-Tox were able to identify 52 and 50 samples with true-positive results. Tox-A/B and TR-Tox-A would have missed 15 and 31% of cases of C. difficile-associated diarrhea, respectively, if used alone.

* Corresponding author. Mailing address: Department of Clinical Microbiology and Infection Control, London Health Sciences Centre, Room C307, Westminster Tower, 800 Commissioner's Rd. East, London, Ontario N6A 4G5, Canada. Phone: (519) 685-8149. Fax: (519) 685-8203. E-mail: zafar.hussain{at}lhsc.on.ca.

Journal of Clinical Microbiology, October 2004, p. 4863-4865, Vol. 42, No. 10
0095-1137/04/$08.00+0     DOI: 10.1128/JCM.42.10.4863-4865.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.



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