Clinical Comparison of Latex Agglutination and Cytotoxin Assay for Detection of Clostridium difficile Toxin in Feces

Woods, Gail L.; Yam, Paul

doi:10.1093/labmed/19.10.649

Cited by 6 publications

(5 citation statements)

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“…The purported detection of C. difficile toxin A in fecal specimens by a commercial latex agglutination test has been the subject of much controversy (14,15,144 (37,143,209,247,288,294,295). However, the published positive and negative predictive values have varied considerably, ranging from 63 to 98%.…”

Section: Latex Agglutination Testsmentioning

confidence: 99%

Clostridium difficile: clinical disease and diagnosis

1993

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Clostridium difficile is an opportunistic pathogen that causes a spectrum of disease ranging from antibiotic-associated diarrhea to pseudomembranous colitis. Although the disease was first described in 1893, the etiologic agent was not isolated and identified until 1978. Since clinical and pathological features of C. difficile-associated disease are not easily distinguished from those of other gastrointestinal diseases, including ulcerative colitis, chronic inflammatory bowel disease, and Crohn's disease, diagnostic methods have relied on either isolation and identification of the microorganism or direct detection of bacterial antigens or toxins in stool specimens. The current review focuses on the sensitivity, specificity, and practical use of several diagnostic tests, including methods for culture of the etiologic agent, cellular cytotoxicity assays, latex agglutination tests, enzyme immunoassay systems, counterimmunoelectrophoresis, fluorescent-antibody assays, and polymerase chain reactions.

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Section: Latex Agglutination Testsmentioning

confidence: 99%

Clostridium difficile: clinical disease and diagnosis

1993

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“…difficile-associated disease (7,14). The sensitivity of the latex test, however, has ranged from 68 to 90% (3, 7, 11).…”

Section: Discussionmentioning

confidence: 99%

“…A homogeneous blue or blue-green dot appearing in the center of the membrane surface within a 3-min observation period was considered positive for C. difficile toxin A. Latex agglutination. The latex agglutination test was performed and interpreted according to the directions of the manufacturer (14). Stool and test buffer was mixed and centrifuged.…”

Section: Methodsmentioning

confidence: 99%

“…marketed a latex agglutination kit (Culturette Brand CDT C. difficile test) specific for C. difficile toxin A. The test has since been proven not specific for toxin A (10); however, in clinical studies, this latex test has correlated well with the presence of C. difficile-associated diarrhea (7,14). Difco Laboratories (Ann Arbor, Mich.) recently developed a dot immunobinding assay (C. diff-CUBE) for rapid detection of C. difficile toxin A in stool specimens.…”

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confidence: 99%

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Comparison of a dot immunobinding assay, latex agglutination, and cytotoxin assay for laboratory diagnosis of Clostridium difficile-associated diarrhea

Woods

Iwen

1990

J Clin Microbiol

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C. diff-CUBE, a dot immunobinding assay (DIA) (Difco Laboratories, Ann Arbor, Mich.) for detection of Clostridium difficile toxin A in stool specimens, was compared with latex agglutination (LA) (Marion Laboratories, Kansas City, Mo.) and cytotoxin assay (CTA) for the laboratory diagnosis of C. difficileassociated diarrhea. A total of 200 stool specimens collected from 169 patients with suspected C. difficile diarrhea were tested. Of the 198 specimens evaluated by all three methods, 36 (18%) from 36 patients were positive by one or more of the tests. Twenty-five, 26, and 23 specimens were positive by CTA, DIA, and LA, respectively; 14 were positive by all three methods. Eight specimens yielded nonspecific LA test results; all eight were negative by CTA, and one was positive by DIA. DIA results agreed with CTA results in 183 (92%) cases and with LA results in 175 (88%) cases. CTA and LA results agreed in 179 (90%) cases. Freezing of the specimen did not appear to adversely affect either the DIA or LA test. These preliminary results suggest that C. diff-CUBE may be useful as a rapid screen for the diagnosis of C. difficile-associated diarrhea. However, for optimum laboratory diagnosis, further testing of all stools that are negative by DIA is warranted.

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