Institut de Microbiologie, CHU Lille, Lille, France.
Expert Rev Mol Diagn. 2013 Sep;13(7):681-92. doi: 10.1586/14737159.2013.829705.
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. Reporting the DNA load of toxigenic C. difficile in the stool sample may represent a solution. Diagnostic algorithms combining immunoassays and NAATs could also improve the specificity and reduce the global cost of this analysis.
核酸扩增技术 (NAATs) 代表了艰难梭菌 (C. difficile) 感染诊断的重大进展。本综述分析了用于艰难梭菌感染分子诊断的不同选择，以及 NAATs 的优缺点。比较了七种商业 NAATs 的性能 (BD GeneOhm Cdiff、Illumigene C. difficile、Xpert C. difficile、BD Max Cdiff、Portrait Toxigenic C. difficile、ProGastro Cd、Seeplex Diarrhea ACE)。NAATs 的灵敏度和快速性非常出色：应进一步努力区分感染和定植。报告粪便样本中产毒艰难梭菌的 DNA 载量可能是一种解决方案。结合免疫测定和 NAATs 的诊断算法也可以提高特异性并降低这种分析的总体成本。
