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Sachin K Garg, Kyle Lu, John Duncan, Lance R Peterson, Oliver Liesenfeld
Clostridium difficile infection is a significant health burden, and innovative solutions are needed to shorten time to diagnosis and improve infection control. We evaluated the performance of the cobas® Cdiff test for use on the cobas® Liat® System (cobas® Liat® Cdiff), a single-sample, on-demand, and automated molecular solution with a 20-min turnaround time. The limit of detection was 45-90 colony-forming units (CFUs)/swab for toxigenic strains that covered the most prevalent toxinotypes, including the hyper-virulent epidemic 027/BI/NAP1 strain...
December 18, 2017: European Journal of Microbiology & Immunology
Parul A Patel, Donna M Schora, Kamaljit Singh, Lance R Peterson
Clostridium difficile infection (CDI) is not declining in the United States. Nucleic acid amplification tests (NAAT) are used as part of active surveillance testing programs to prevent healthcare associated infection. The objective of this study was to validate the cobas® Cdiff Test on the cobas® 4800 System (cobas®) within a 4-hospital system using prospectively collected peri-rectal swabs from asymptomatic patients at admission and during monthly intensive care unit (ICU) screening in an Infection Control CDI reduction program...
January 24, 2018: Journal of Clinical Microbiology
Hanjiang Lai, Chen Huang, Jian Cai, Julian Ye, Jun She, Yi Zheng, Liqian Wang, Yelin Wei, Weijia Fang, Xianjun Wang, Yi-Wei Tang, Yun Luo, Dazhi Jin
We employed a multiplex polymerase chain reaction (PCR) coupled with capillary electrophoresis (mPCR-CE) targeting six Clostridium difficile genes, including tpi, tcdA, tcdB, cdtA, cdtB, and a deletion in tcdC for simultaneous detection and characterization of toxigenic C. difficile directly from fecal specimens. The mPCR-CE had a limit of detection of 10 colony-forming units per reaction with no cross-reactions with other related bacterial genes. Clinical validation was performed on 354 consecutively collected stool specimens from patients with suspected C...
October 17, 2017: Frontiers of Medicine
María C Legaria, Raquel Rollet, Ana Di Martino, Liliana Castello, Claudia Barberis, María A Rossetti, María C Guardati, Liliana Fernández Canigia, Graciela Carloni, Mirta Litterio, Marta Rocchi, Eduardo G Anchart, Fernando M Trejo, Jessica Minnaard, Diana Klajn, Silvia C Predari
The best laboratory diagnostic approach to detect Clostridioides [Clostridium] difficile infection (CDI) is a subject of ongoing debate. With the aim of evaluating four laboratory diagnostic methods, 250 unformed stools from patients with suspected CDI submitted to nine medical center laboratories from November 2010 to December 2011, were studied using: (1) an immunochromatographic rapid assay test that combines the qualitative determination of glutamate dehydrogenase (GDH) plus toxins A and B (QAB), the CDIFF QUIK CHEK COMPLETE assay; (2) an enzyme immunoassay for qualitative determination of toxins A and B, the RIDASCREEN™ C...
January 2018: Revista Argentina de Microbiología
Lance R Peterson, Stephen A Young, Thomas E Davis, Zi-Xuam Wang, John Duncan, Christopher Noutsios, Oliver Liesenfeld, John C Osiecki, Michael A Lewinski
Nucleic acid amplification tests (NAATs) are reliable tools for the detection of toxigenic Clostridium difficile from unformed (liquid or soft) stool samples. The objective of this study was to evaluate performance of the cobas Cdiff test on the cobas 4800 system using prospectively collected stool specimens from patients suspected of having C. difficile infection (CDI). The performance of the cobas Cdiff test was compared to the results of combined direct and broth-enriched toxigenic culture methods in a large, multicenter clinical trial...
December 2017: Journal of Clinical Microbiology
Emrah Salman, Belkıs Levent, Zeynep Ceren Karahan
Clostridium difficile infection is one of the most important hospital-acquired infections. Infections caused by hypervirulent C.difficile strains which produce toxins at high levels, have higher morbidity and mortality rates, more complications and relapses. They are characterized by higher sporulation ratios and resistance rates for fluoroquinolones. In order to prevent serious morbidities, mortalities and remarkable increase in health costs, highly pathogenic C.difficile strains must be identified before causing severe outbreaks...
July 2017: Mikrobiyoloji Bülteni
Michael J Mashock, Matthew L Faron, Blake W Buchan, Nathan A Ledeboer
Liquid-based microbiology (LBM) devices incorporating flocked swabs and preservation medium ease transport of specimens and improve specimen yield compared to traditional fiber wound swabs; however, the performance of LBM collection devices has not been evaluated in many molecular assays. It is unclear how the differences in matrix and specimen loading with an LBM device will affect test performance compared to traditional collection devices. The purpose of this study was to evaluate the performance of specimens collected in FecalSwab transport medium (Copan Diagnostics, Murrieta, CA) compared to unpreserved stool using the Cepheid Xpert C...
October 2017: Journal of Clinical Microbiology
Y Paitan, T Miller-Roll, A Adler
OBJECTIVES: Rapid and accurate detection of Clostridium difficile in stool affects patient treatment and containment efforts. Detection of C. difficile toxin genes using nucleic acid amplification techniques (NAAT) is part of a multistep algorithm. Our objective was to directly compare the diagnostic accuracy and applicability of six commercial C. difficile NAAT. METHODS: Two hundred ten specimens were analysed in parallel by six commercial NAAT. Toxigenic culture was used as a reference method...
August 2017: Clinical Microbiology and Infection
P Putsathit, M Maneerattanaporn, P Piewngam, P Kiratisin, T V Riley
Little is known about Clostridium difficile infection (CDI) in Asia generally, and specifically in Thailand. Given the high prevalence of inappropriate antibiotic usage in this region, CDI is likely to be common. This study investigated the prevalence and molecular epidemiology of CDI in Thailand. Stool specimens collected from inpatients with diarrhoea at Siriraj hospital in Bangkok (n = 422) were cultured on ChromID Cdiff agar and any presumptive C. difficile colonies were identified, PCR ribotyped and toxin profiled...
January 2017: New Microbes and New Infections
B Kullin, J Wojno, V Abratt, S J Reid
The molecular epidemiology of C. difficile strains causing disease in South Africa is currently unknown. Previously, multidrug resistant ribotype (RT)017 strains were those most commonly isolated from patients with diarrhoea attending Groote Schuur Hospital in Cape Town, South Africa. This larger study aimed to investigate the molecular epidemiology and antibiotic susceptibility profiles of C. difficile strains in the greater Cape Town and regional areas. C. difficile strains were isolated from patients with diarrhoea attending hospitals in the Western Cape region of South Africa that tested positive using the GeneXpert CDiff diagnostic test...
January 2017: European Journal of Clinical Microbiology & Infectious Diseases
Daniela Pires, Virginie Prendki, Gesuele Renzi, Carolina Fankhauser, Valerie Sauvan, Benedikt Huttner, Jacques Schrenzel, Stephan Harbarth
BACKGROUND: The role of asymptomatic carriers of toxigenic Clostridium difficile (TCD) in nosocomial cross-transmission remains debatable. Moreover, its relevance in the elderly has been sparsely studied. OBJECTIVES: To assess asymptomatic TCD carriage in an acute care geriatric population. METHODS: We performed a prospective cohort study at the 296-bed geriatric hospital of the Geneva University Hospitals. We consecutively recruited all patients admitted to two 15-bed acute-care wards...
2016: Antimicrobial Resistance and Infection Control
Naayil Rajabally, Brian Kullin, Kaleemuddeen Ebrahim, Tunehafo Brock, Andrej Weintraub, Andrew Whitelaw, Colleen Bamford, Gillian Watermeyer, Sandie Thomson, Valerie Abratt, Sharon Reid
Accurate diagnosis of Clostridium difficile infection is essential for disease management. A clinical and molecular analysis of C. difficile isolated from symptomatic patients at Groote Schuur Hospital, South Africa, was conducted to establish the most suitable clinical test for the diagnosis and characterisation of locally prevalent strains. C. difficile was detected in stool samples using enzyme-based immunoassays (EIA) and nucleic acid amplification methods, and their performance was compared to C. difficile isolation using direct selective culture combined with specific PCR to detect the C...
February 9, 2016: Journal of Medical Microbiology
Bo-Moon Shin, Sun Mee Yoo, Won Chang Shin
BACKGROUND: We evaluated the performance of four commercial nucleic acid amplification tests (NAATs: Xpert C. difficile, BD MAX Cdiff, IMDx C. difficile for Abbott m2000, and Illumigene C. difficile) for direct and rapid detection of Clostridium difficile toxin genes. METHODS: We compared four NAATs on the same set of 339 stool specimens (303 prospective and 36 retrospective specimens) with toxigenic culture (TC). RESULTS: Concordance rate among four NAATs was 90...
March 2016: Annals of Laboratory Medicine
Raquel Moure, Ángeles Cañizares, María Muíño, Margarita Lobato, Ana Fernández, María Rodríguez, Maria José Gude, Maria Tomás, Germán Bou
The new cobas® Cdiff and cobas® MRSA/SA tests were compared with conventional methods for the rapid detection of toxigenic Clostridium difficile and methicillin-resistant Staphylococcus aureus. The final concordance between cobas Cdiff Test and GDH/toxin gene screening was 97.62% and between cobas MRSA/SA Test and chromogenic culture, 91.30%, respectively.
January 2016: Journal of Microbiological Methods
Paweł Karpiński, Hanna Pituch, Dominika Lachowicz, Michał Piotrowski, Piotr Obuch-Woszczatyński
INTRODUCTION: Clostridium difficile is main reason of antibiotic-associated diarrhea in hospitalized patients. Diagnostic method for detection of Clostridium difficile infection (CDI) are limited to an enzyme immunoassays (EIAs), while the culture of toxigenic strains is still seen as the gold standard for the laboratory diagnosis. The aim of this study was to compare growth of C. difficile strains belonging to different polymerase chain reaction (PCR) ribotypes on new ChromID C. difficile Agar (CDIFF, bioMérieux, Marcy l'Etoile, France)...
2015: Medycyna Doświadczalna i Mikrobiologia
Jaeeun Yoo, Hyeyoung Lee, Kang Gyun Park, Gun Dong Lee, Yong Gyu Park, Yeon-Joon Park
We evaluated the performance of the 3 automated systems (Cepheid Xpert, BD MAX, and IMDx C. difficile for Abbott m2000) detecting Clostridium difficile toxin gene compared to toxigenic culture. Of the 254 stool specimens tested, 87 (48 slight, 35 moderate, and 4 heavy growth) were toxigenic culture positive. The overall sensitivities and specificities were 82.8% and 98.8% for Xpert, 81.6% and 95.8% for BD MAX, and 62.1% and 99.4% for IMDx, respectively. The specificity was significantly higher in IMDx than BD MAX (P= 0...
September 2015: Diagnostic Microbiology and Infectious Disease
Abdullah Kilic, Mohammad J Alam, Naradah L Tisdel, Dhara N Shah, Mehmet Yapar, Todd M Lasco, Kevin W Garey
BACKGROUND: The aim of this study was to develop and validate a multiplex real-time PCR assay for simultaneous identification and toxigenic type characterization of Clostridium difficile. METHODS: The multiplex real-time PCR assay targeted and simultaneously detected triose phosphate isomerase (tpi) and binary toxin (cdtA) genes, and toxin A (tcdA) and B (tcdB) genes in the first and sec tubes, respectively. The results of multiplex real-time PCR were compared to those of the BD GeneOhm Cdiff assay, targeting the tcdB gene alone...
May 2015: Annals of Laboratory Medicine
J J Hirvonen, S-S Kaukoranta
In this study, the usability and performance of GenomEra™ C. difficile and BD Max™ Cdiff nucleic acid amplification tests (NAATs) for the detection of toxigenic Clostridium difficile were investigated in comparison with toxigenic culture and C. difficile toxin A- and toxin B-detecting immunochromatographic antigen (IA) test, the Tox A/B QuikChek®. In total, 302 faecal specimens were collected, 113 of which were in parallel to conventional sample containers and FecalSwab liquid-based microbiology (LBM) tubes...
May 2015: European Journal of Clinical Microbiology & Infectious Diseases
Papanin Putsathit, Justin Morgan, Damien Bradford, Nelly Engelhardt, Thomas V Riley
The Becton Dickinson (BD) PCR-based GeneOhm Cdiff assay has demonstrated a high sensitivity and specificity for detecting Clostridium difficile. Recently, the BD Max platform, using the same principles as BD GeneOhm, has become available in Australia. This study aimed to investigate the sensitivity and specificity of BD Max Cdiff assay for the detection of toxigenic C. difficile in an Australian setting. Between December 2013 and January 2014, 406 stool specimens from 349 patients were analysed with the BD Max Cdiff assay...
February 2015: Pathology
Donald Chiang, Sally Ng, My-Van La, Roland Jureen, Raymond T P Lin, Jeanette W P Teo
In a clinical setting with low prevalence of 'epidemic' PCR ribotype 027, the BD MAX Cdiff assay was found to be a suitable alternative to the Xpert C. difficile assay for the detection of toxigenic Clostridium difficile in samples which are reflex PCR tested after obtaining a discrepant immunoassay result. There was no significant difference between the sensitivities and specificities of both commercial molecular assays.
December 2014: Anaerobe
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