Yang John Jeongseok, Nam You Sun, Kim Min Jin, Cho Sun Young, You Eunkyung, Soh Yun Soo, Lee Hee Joo
Department of Laboratory Medicine, School of Medicine, Kyung Hee University, Seoul, Korea. ; Department of Medicine, Kyung Hee University Graduate School, Seoul, Korea.
Department of Biomedical Science, Kyung Hee University Graduate School, Seoul, Korea.
Yonsei Med J. 2014 Jul;55(4):994-8. doi: 10.3349/ymj.2014.55.4.994.
Clostridium difficile (C. difficile) is an important cause of nosocomial diarrhea. Diagnostic methods for detection of C. difficile infection (CDI) are shifting to molecular techniques, which are faster and more sensitive than conventional methods. Although recent advances in these methods have been made in terms of their cost-benefit, ease of use, and turnaround time, anaerobic culture remains an important method for detection of CDI.
In efforts to evaluate a novel chromogenic medium for the detection of C. difficile (chromID CD agar), 289 fecal specimens were analyzed using two other culture media of blood agar and cycloserine-cefoxitin-fructose-egg yolk agar while enzyme immunosorbent assay and polymerase chain reaction-based assay were used for toxin detection.
ChromID showed the highest detection rate among the three culture media. Both positive rate and sensitivity were higher from chromID than other culture media. ChromID was better at detecting toxin producing C. difficile at 24 h and showed the highest detection rate at both 24 h and 48 h.
Simultaneous use of toxin assay and anaerobic culture has been considered as the most accurate and sensitive diagnostic approach of CDI. Utilization of a more rapid and sensitive chromogenic medium will aid in the dianogsis of CDI.
艰难梭菌是医院内腹泻的重要病因。艰难梭菌感染(CDI)的诊断方法正转向分子技术,其比传统方法更快、更灵敏。尽管这些方法在成本效益、易用性和周转时间方面取得了最新进展,但厌氧培养仍然是检测CDI的重要方法。
为评估一种用于检测艰难梭菌的新型显色培养基(chromID CD琼脂),使用血琼脂和环丝氨酸-头孢西丁-果糖-蛋黄琼脂这两种其他培养基对289份粪便标本进行分析,同时采用酶免疫吸附测定法和基于聚合酶链反应的测定法进行毒素检测。
ChromID在三种培养基中显示出最高的检出率。ChromID的阳性率和灵敏度均高于其他培养基。ChromID在24小时时检测产毒素艰难梭菌的能力更强,在24小时和48小时时均显示出最高的检出率。
同时使用毒素检测和厌氧培养被认为是CDI最准确、最灵敏的诊断方法。使用更快速、灵敏的显色培养基将有助于CDI的诊断。