Detection of toxigenic colonization in patients admitted to the hospital for chemotherapy or haematopoietic cell transplantation.

Increasing evidence suggests that asymptomatic carriers are an important source of healthcare-associated infection. However, it is not known which test for the detection of colonization is most sensitive in patients with haematological malignancies. We performed a prospective cohort study of 101 patients with haematological malignancies who had been admitted to the hospital for scheduled chemotherapy or haematopoietic cell transplantation. Each patient provided a formed stool sample. We compared the performance of five different commercially available assays, using toxigenic culture as the reference method. The prevalence of toxigenic colonization as determined by toxigenic culture was 14/101 (14 %). The Cepheid Xpert PCR /Epi was the most sensitive test for the detection of toxigenic colonization, with 93 % sensitivity and 99 % negative predictive value. Our findings suggest that the Xpert PCR /Epi could be used to rule out toxigenic colonization in this population.