Ryan R W, Kwasnik I, Clout D, Tilton R C
Ann Clin Lab Sci. 1987 Jul-Aug;17(4):232-5.
Currently, the method of choice for the laboratory diagnosis of Clostridium difficile disease is the detection of cytotoxin in stool filtrates by tissue culture. Since many hospital laboratories do not have tissue culture facilities, there is a need for a rapid test which is both sensitive and specific to diagnose C. difficile disease. A commercial latex agglutination was compared with the conventional cytotoxin tissue culture assay for the detection of C. difficile or its toxin(s) in fecal specimens. Of the 574 specimens evaluated, 111 were cytotoxin positive while 97 were positive by the latex agglutination test. There were 17 specimens positive by latex agglutination but negative by tissue culture assay. The overall sensitivity and specificity of the CDT latex test was 86.1 percent and 95.3 percent respectively. This rapid latex test can serve as an excellent screening procedure for the presence of C. difficile. Those specimens positive by the latex test should be further evaluated for the presence of cytotoxin by tissue culture.
目前，艰难梭菌疾病实验室诊断的首选方法是通过组织培养检测粪便滤液中的细胞毒素。由于许多医院实验室没有组织培养设施，因此需要一种快速检测方法，既能敏感又能特异地诊断艰难梭菌疾病。将一种商业乳胶凝集试验与传统的细胞毒素组织培养试验进行比较，以检测粪便标本中的艰难梭菌或其毒素。在评估的574份标本中，111份细胞毒素检测呈阳性，而乳胶凝集试验有97份呈阳性。有17份标本乳胶凝集试验呈阳性，但组织培养试验呈阴性。CDT乳胶试验的总体敏感性和特异性分别为86.1%和95.3%。这种快速乳胶试验可作为检测艰难梭菌的优良筛查方法。乳胶试验呈阳性的标本应通过组织培养进一步评估细胞毒素的存在情况。
