Results of a prospective, 18-month clinical evaluation of culture, cytotoxin testing, and culturette brand (CDT) latex testing in the diagnosis of Clostridium difficile-associated diarrhea (original) (raw)

1988, Diagnostic Microbiology and Infectious Disease

An 18-mo evaluation of culture, cytotoxin, and latex testing for Clostridium difficile was performed between July 1, 1985, and December 31, 1986, on 1,536 specimens from 1,406 patients during evaluation of diarrhea. All cases with at least one test positive were investigated for clinical status. There were 144 Clostridium difficile-associated diarrhea (CAD) patients; 139 (97%) were positive by culture, 96 (67%) by cytotoxin, and 98 (68%) by latex testing. In the 1,262 non-CAD patients with diarrheal stool, 89 (7.1%) were positive by culture, 18 (1.4%) by cytotoxin, and 68 (5.4%) by the latex test. No CAD patient was positive by cytotoxin testing only, and two were positive by latex testing only. The culture and cytotoxin positivity were similar to our previous reports of 90-97% and 70-73%, respectively. Latex sensitivity (68%) was comparable to that of cytotoxin testing in this large group of patients (p > 0.5). Overall, in the 1,262 patients without clinical evidence of Clostridium difficile disease, positive tests by latex testing (5.4%) were intermediate between those of culture (7.1%, p < O. 1) and cytotoxin (1.4%, p < 0.001). Enzyme immunoassay for detection of Clostridium difficile ~oxins A and B in patients with antibiotic-associated diarrhoea and colitis. Eur J Clin Microbiol 4:102-107. Aronsson B, Mollby R, Nord CE (1984) Diagnosis and epidemiology of Clostridium difficile enterocolitis in Sweden.