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Yossi Paitan, Tamar Miller Roll, Amos Adler
OBJECTIVES: Rapid and accurate detection of C. difficile in stool impacts 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 6 commercial C. difficile NAAT assays. METHODS: In this study, 210 specimens were analysed in parallel by 6 commercial NAAT. Toxigenic culture was used as a reference method...
February 18, 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
Daniel R Knight, Michele M Squire, Thomas V Riley
Clostridium difficile is a well-known enteric pathogen of humans and the causative agent of high-morbidity enteritis in piglets aged 1 to 7 days. C. difficile prevalence in Australian piglets is as high as 70%. The current diagnostic assays have been validated only for human infections, and there are no published studies assessing their performance in Australian piglets. We evaluated the suitability of five assays for detecting C. difficile in 157 specimens of piglet feces. The assays included a loop-mediated isothermal amplification (LMIA)-PCR for tcdA (illumigene C...
November 2014: Journal of Clinical Microbiology
Jeremy J Gilbreath, Punam Verma, April N Abbott, Susan M Butler-Wu
We compared the Verigene Clostridium difficile test (Nanosphere, Northbrook, IL, USA), the Simplexa C. difficile Universal Direct (Focus Diagnostics, Cypress, CA, USA), the BD MAX Cdiff (Becton Dickinson, Franklin Lakes, NJ, USA), and the Xpert C. difficile (Cepheid, Sunnyvale, CA, USA) assays for the detection of toxigenic C. difficile. One hundred and ninety deidentified, remnant diarrheal specimens were included in this study. After resolution of discordant results by toxigenic culture, the Xpert C. difficile assay displayed the highest sensitivity (100%), with a specificity of 98...
September 2014: Diagnostic Microbiology and Infectious Disease
J Hart, P Putsathit, D R Knight, L Sammels, T V Riley, A Keil
The increasing incidence of Clostridium difficile infection (CDI) in paediatric hospitalised populations, combined with the emergence of hypervirulent strains, community-acquired CDI and the need for prompt treatment and infection control, makes the rapid, accurate diagnosis of CDI crucial. We validated commonly used C. difficile diagnostic tests in a paediatric hospital population. From October 2011 to January 2012, 150 consecutive stools were collected from 75 patients at a tertiary paediatric hospital in Perth, Western Australia...
September 2014: European Journal of Clinical Microbiology & Infectious Diseases
K A Stellrecht, A A Espino, V P Maceira, S M Nattanmai, S A Butt, D Wroblewski, G E Hannett, K A Musser
Clostridium difficile-associated diarrhea is a well-recognized complication of antibiotic use. Historically, diagnosing C. difficile has been difficult, as antigen assays are insensitive and culture-based methods require several days to yield results. Nucleic acid amplification tests (NAATs) are quickly becoming the standard of care. We compared the performance of two automated investigational/research use only (IUO/RUO) NAATs for the detection of C. difficile toxin genes, the IMDx C. difficile for Abbott m2000 Assay (IMDx) and the BD Max Cdiff Assay (Max)...
May 2014: Journal of Clinical Microbiology
Noah A Brown, William D Lebar, Carol L Young, Rosemary E Hankerd, Duane W Newton
Clostridium difficile infection (CDI) caused by toxigenic strains of C. difficile is primarily a nosocomial infection with increasing prevalence. Stool specimens are typically collected in Cary-Blair transport medium to maximize culture-based detection of common stool pathogens. The goal of this study was to establish an analytically accurate and efficient algorithm for the detection of CDI in our patient population using samples collected in Cary-Blair transport medium. In addition, we wished to determine whether the sensitivity and specificity of PCR was affected by freezing samples before testing...
March 8, 2011: Infectious Disease Reports
J Stahlmann, M Schönberg, M Herrmann, L von Müller
A two-step diagnostic algorithm is recommended to detect Clostridium difficile infections; however, samples are regularly found that are glutamate dehydrogenase (GDH) positive but stool toxin negative. In the present single-centre prospective study we focused on these 'difficult-to-interpret' samples and characterized them by anaerobic culture, toxigenic culture, slpA sequence typing and multiplex PCR (GenoType CDiff). The majority of stool toxin A and B-negative samples have been caused by toxigenic strains including ribotype 027...
September 2014: Clinical Microbiology and Infection
Rémi Le Guern, Stéphanie Herwegh, René Courcol, Frédéric Wallet
Nucleic acid amplification techniques (NAATs) represent a major advance in the diagnosis of Clostridium difficile (C. difficile) infection. This review analyzes the different options available for a molecular diagnosis of C. difficile infection, as well as the strengths and weaknesses of NAATs. The performances of seven commercials NAATs are compared (BD GeneOhm Cdiff, Illumigene C. difficile, Xpert C. difficile, BD Max Cdiff, Portrait Toxigenic C. difficile, ProGastro Cd, Seeplex Diarrhea ACE). The sensitivity and the rapidity of NAATs are excellent: additional efforts should focus on the discrimination between infection and colonization...
September 2013: Expert Review of Molecular Diagnostics
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