Department of Medical Microbiology, 2nd Faculty of Medicine, Charles University, Motol University Hospital, Prague, Czech Republic
Department of Medical Microbiology, 2nd Faculty of Medicine, Charles University, Motol University Hospital, Prague, Czech Republic.
J Clin Microbiol. 2019 Sep 24;57(10). doi: 10.1128/JCM.00710-19. Print 2019 Oct.
() infection (CDI) is the most common causative pathogen of health care-associated gastrointestinal infections; however, due to the overlap of clinical symptoms with those of other causes of acute gastroenteritis, the selection of the most appropriate laboratory test is difficult. From April to October 2018, 640 stool samples requested for CDI testing were examined using the mariPOC CDI and Gastro test (ArcDia), which allows the detection of glutamate dehydrogenase (GDH) and toxin A/B, norovirus genogroups GI and GII.4, rotavirus, adenovirus, and spp. In parallel, the C. Diff Quik Chek Complete test (Alere) was used as a routine diagnostic assay, and toxigenic culture was used as a reference method. The sensitivity of the mariPOC CDI and Gastro test was comparable to that of C. Diff Quik Chek Complete for the detection of GDH (96.40% [95% confidence interval {CI}, 91.81% to 98.82%] versus 95.68% [95% CI, 90.84 to 98.40%]; = 1.00) and was higher for the detection of toxin A/B (66.67% [95% CI, 57.36 to 75.11%] versus 55.56% [95% CI, 46.08 to 64.74%]; = 0.00). The specificity of the mariPOC CDI and Gastro test was lower than that of C. Diff Quik Chek Complete for GDH detection (95.21% [95% CI, 92.96% to 96.91%] versus 97.60% [95% CI, 95.85% to 98.76%]; = 0.04) and comparable to that of C. Diff Quik Chek Complete for toxin A/B detection (99.24 [95% CI, 98.05% to 99.79%] versus 99.81% [95% CI, 98.94% to 100.0%]; = 0.37). In 29 cases (4.53%), other causative agents of diarrhea were detected ( spp. [ = 17], rotavirus [ = 7], and norovirus genogroup GII.4 [ = 5]).
()感染(CDI)是最常见的医源性胃肠道感染病原体;然而,由于其临床症状与其他急性胃肠炎的病因重叠,因此很难选择最合适的实验室检测方法。2018 年 4 月至 10 月,我们使用 mariPOC CDI 和 Gastro 试验(ArcDia)检测了 640 份要求进行 CDI 检测的粪便样本,该试验可同时检测谷氨酸脱氢酶(GDH)和毒素 A/B、诺如病毒基因组 GI 和 GII.4、轮状病毒、腺病毒和 spp。同时,我们使用 C. Diff Quik Chek Complete 试验(Alere)作为常规诊断检测方法,并用产毒培养作为参考方法。mariPOC CDI 和 Gastro 试验检测 GDH 的灵敏度与 C. Diff Quik Chek Complete 检测方法相当(96.40%[95%置信区间{CI},91.81%至 98.82%]与 95.68%[95%CI,90.84%至 98.40%]; = 1.00),检测毒素 A/B 的灵敏度更高(66.67%[95%CI,57.36%至 75.11%]与 55.56%[95%CI,46.08%至 64.74%]; = 0.00)。mariPOC CDI 和 Gastro 试验检测 GDH 的特异性低于 C. Diff Quik Chek Complete 检测方法(95.21%[95%CI,92.96%至 96.91%]与 97.60%[95%CI,95.85%至 98.76%]; = 0.04),检测毒素 A/B 的特异性与 C. Diff Quik Chek Complete 检测方法相当(99.24%[95%CI,98.05%至 99.79%]与 99.81%[95%CI,98.94%至 100.0%]; = 0.37)。在 29 例(4.53%)中,还检测到了其他腹泻病原体( spp.[ = 17]、轮状病毒[ = 7]和诺如病毒基因组 GII.4[ = 5])。