Rapid detection of Clostridium difficile toxins and laboratory diagnosis of Clostridium difficile infections

Abstract

Laboratory tests for CDI can broadly detect either the organisms or its toxins. Currently, several laboratory tests are used for diagnosis of CDI, including toxigenic culture, glutamate dehydrogenase detection, nucleic acid amplification testing, cell cytotoxicity assay, and enzyme immunoassay towards toxin A and/or B. This review focuses on the rapid testing of C. difficile toxins and currently available methods for diagnosis of CDI, giving an overview of the role that the toxins rapid detecting plays in clinical diagnosis of CDI.

2019 update of the WSES guidelines for management of Clostridioides (Clostridium) difficile infection in surgical patients

“…GDH is an enzyme produced by C . difficile in relatively large amounts compared with toxins A and B [209, 210]. A positive GDH assay only documents the presence of C .…”

“…difficile from diarrheal stool specimens was documented in the early 1990s. NAATs possess a series of advantages such as excellent sensitivity and specificity, low complexity, simplified reporting, reduced need for repeat testing, and improved turnaround time [209–212].…”

Advances in the diagnosis and treatment of Clostridium difficile infections

“…Accordingly, NAATs are regarded as the most cost-effective method for the diagnosis of CDI 25 . Most NAATs target the encoding genes of TcdB, TcdA, and/or the binary toxin 26 – 28 . In particular, some NAATs such as multiplex NAATs can simultaneously detect C. difficile strains and toxin encoding genes from stool samples 29 .…”

Antibiotic exposure and risk of community-associated Clostridium difficile infection: A self-controlled case series analysis

“…In addition, the laboratory tests used for the diagnosis of C difficile infection have changed over the years of the study from those based on enzyme-linked immunosorbent assays to DNA-based assays. 11 The DNA-based tests are more sensitive than their predecessors and have been demonstrated to increase the detection of C difficile toxin by up to 2-fold. 12 The year variable was included in the final model to account for possible confounding bias due to this temporal change in laboratory tests and to account for changes in the age of patients.…”