Evaluation of the Xpert Clostridium difficile Assay for the Diagnosis of Clostridium difficile Infection.
10.3343/alm.2012.32.5.355
- Author:
Saeam SHIN
1
;
Minkyung KIM
;
Myungsook KIM
;
Heejung LIM
;
Heejung KIM
;
Kyungwon LEE
;
Yunsop CHONG
Author Information
1. Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, Korea. hjkim12@yuhs.ac
- Publication Type:Brief Communication ; Evaluation Studies
- Keywords:
Clostridium difficile;
Real-time PCR;
Enzyme immunoassay
- MeSH:
Clostridium Infections/*diagnosis/epidemiology/microbiology;
Clostridium difficile/genetics/*isolation & purification/metabolism;
Face/microbiology;
Humans;
Multiplex Polymerase Chain Reaction;
Prevalence;
Reagent Kits, Diagnostic/*standards;
Sensitivity and Specificity
- From:Annals of Laboratory Medicine
2012;32(5):355-358
- CountryRepublic of Korea
- Language:English
-
Abstract:
Infection with Clostridium difficile is a growing concern because of the increasing prevalence and spread of nosocomial infections. Emergence of the hypervirulent 027/NAP1/BI strain is also notable. Existing diagnostic methods have low sensitivity or are time-consuming. Therefore, establishing a rapid and accurate microbiological diagnostic assay is needed. We evaluated the Xpert C. difficile assay (Xpert CD assay; Cepheid, USA) to detect toxigenic C. difficile. This assay is a real-time multiplex PCR assay that can be used to detect toxigenic C. difficile strains and differentiate the C. difficile presumptive 027/NAP1/BI strain. A total of 253 loose stool specimens were collected and toxigenic cultures, VIDAS C. difficile A & B assays (VIDAS CDAB assay; bioMerieux, France), and the Xpert CD assay were performed. In comparison to toxigenic cultures, the sensitivity, specificity, and positive and negative predictive values were 100%, 94.6%, 83.1%, and 100%, respectively, for the Xpert CD assay and 40.8%, 98.0%, 100%, and 88.9%, respectively, for VIDAS CDAB assay. Because of the low prevalence of the PCR ribotype 027 in Korea, the evaluation of the usefulness of the Xpert CD assay for screening for the 027 strain was limited. The Xpert CD assay provides great sensitivity in diagnosing toxigenic C. difficile infection. In addition, this method has excellent usability because it is simple and fast.
