使用谷氨酸脱氢酶/毒素酶联免疫吸附试验和实时 PCR 的改良两步算法在艰难梭菌感染诊断中的成本效益。
Cost-effectiveness of a modified two-step algorithm using a combined glutamate dehydrogenase/toxin enzyme immunoassay and real-time PCR for the diagnosis of Clostridium difficile infection.
机构信息
Section of Infectious Diseases, Department of Medicine, Rush University Medical Center, Chicago, IL, USA.
Clinical Microbiology, Department of Pathology, Rush University Medical Center, Chicago, IL, USA.
出版信息
J Microbiol Immunol Infect. 2014 Feb;47(1):75-8. doi: 10.1016/j.jmii.2012.07.008. Epub 2012 Aug 24.
The analytical performance and cost-effectiveness of the Wampole Toxin A/B EIA, the C. Diff. Quik Chek Complete (CdQCC) (a combined glutamate dehydrogenase antigen/toxin enzyme immunoassay), two RT-PCR assays (Progastro Cd and BD GeneOhm) and a modified two-step algorithm using the CdQCC reflexed to RT-PCR for indeterminate results were compared. The sensitivity of the Wampole Toxin A/B EIA, CdQCC (GDH antigen), BD GeneOhm and Progastro Cd RT-PCR were 85.4%, 95.8%, 100% and 93.8%, respectively. The algorithm provided rapid results for 86% of specimens and the remaining indeterminate results were resolved by RT-PCR, offering the best balance of sensitivity and cost savings per test (algorithm ∼US$13.50/test versus upfront RT-PCR ∼US$26.00/test).
我们比较了 Wampole 毒素 A/B EIA、C. Diff. Quik Chek Complete（CdQCC）（一种联合谷氨酸脱氢酶抗原/毒素酶免疫测定法）、两种 RT-PCR 检测法（Progastro Cd 和 BD GeneOhm），以及使用 CdQCC 进行 RT-PCR 检测以解决不确定结果的改良两步算法的分析性能和成本效益。Wampole 毒素 A/B EIA、CdQCC（GDH 抗原）、BD GeneOhm 和 Progastro Cd RT-PCR 的灵敏度分别为 85.4%、95.8%、100%和 93.8%。该算法可快速提供 86%标本的结果，其余不确定结果通过 RT-PCR 解决，每个检测的灵敏度和成本节约达到最佳平衡（算法约为 13.50 美元/检测，而直接进行 RT-PCR 检测约为 26.00 美元/检测）。
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