Veterinary School, Federal University of Minas Gerais, Antônio Carlos Avenue, 6627, Belo Horizonte, MG, 31.270-901, Brazil.
Faculty of Medicine, Federal University of Minas Gerais, Prof. Alfredo Balena Avenue, 190, Belo Horizonte, MG, 30.130-100, Brazil.
Braz J Microbiol. 2020 Sep;51(3):1139-1143. doi: 10.1007/s42770-020-00288-z. Epub 2020 May 4.
Clostridioides (Clostridium) difficile is responsible for most cases of nosocomial diarrhea and, despite the high prevalence of the disease worldwide, the best laboratory diagnostic approach to diagnose C. difficile infection (CDI) is a subject of ongoing debate. Although the use of multiple tests is recommended, the cost of these algorithms commonly exceeds the affordability in some countries. Thus, to improve CDI diagnosis in a university hospital in Brazil, this study analyzed two immunochromatographic tests and one enzyme immunoassay (ELISA) to evaluate the detection of glutamate dehydrogenase (GDH) and A/B toxins of C. difficile. Stool samples of 89 adult patients presenting nosocomial diarrhea during hospitalization were included. The toxigenic culture was used as the reference method. GDH detection by both commercial tests showed high sensitivity (100%) and specificity (92.1%). On the other hand, toxin-based methods showed a sensitivity between 19.2 and 57.7%. In conclusion, the results suggest that rapid tests for GDH detection are not only suitable for CDI diagnosis as screening tests but also as a single method.
艰难梭菌（梭状芽孢杆菌）是导致大多数医院获得性腹泻的原因，尽管该病在全球的患病率很高，但最佳的实验室诊断方法来诊断艰难梭菌感染（CDI）仍然存在争议。尽管建议使用多种检测方法，但这些算法的成本在某些国家通常超出了负担能力。因此，为了改善巴西一家大学医院的 CDI 诊断，本研究分析了两种免疫层析检测和一种酶联免疫吸附试验（ELISA），以评估谷氨酸脱氢酶（GDH）和艰难梭菌 A/B 毒素的检测。纳入了 89 名住院期间出现医院获得性腹泻的成年患者的粪便样本。毒力培养被用作参考方法。两种商业检测方法的 GDH 检测均显示出高灵敏度（100%）和特异性（92.1%）。另一方面，基于毒素的方法的灵敏度在 19.2%至 57.7%之间。总之，这些结果表明，用于检测 GDH 的快速检测不仅适合作为 CDI 诊断的筛选检测，也适合作为单一方法。
