Wilson K H, Silva J, Fekety F R
J Clin Microbiol. 1982 Sep;16(3):464-8. doi: 10.1128/jcm.16.3.464-468.1982.
We evaluated a direct fluorescent-antibody test to detect Clostridium difficile, the most frequent cause of antibiotic-associated colitis. C. difficile organisms were injected into the ear veins of New Zealand White rabbits to induce antibodies, and the globulin fractions of their sera were conjugated to fluorescein isothiocyanate. The resulting conjugate strongly stained all 40 isolates of C. difficile tested. It also stained isolates of C. sordellii, C. bifermentans, C. chauvoei, and C. sporogenes, but not 20 other clostridial isolates or 10 isolates from other species. Results of testing fecal smears with the direct fluorescent-antibody method were compared with results of testing stools for C. difficile toxin and of culturing for C. difficile on a selective medium. A total of 158 fecal specimens from patients with antibiotic-associated diarrhea were tested. In these patients, the fluorescent-antibody test agreed with culture and toxin testing in 93% of the specimens. However, in normal adults, 62% of the fecal specimens from which C. difficile could not be cultured were positive by the fluorescent-antibody test. Absorption of the conjugate with C. sordellii led to a loss of reactivity to other clostridia as well as to 18 of 20 isolates of C. difficile.
我们评估了一种直接荧光抗体试验，用于检测艰难梭菌，它是抗生素相关性结肠炎最常见的病因。将艰难梭菌菌株注入新西兰白兔的耳静脉以诱导产生抗体，然后将其血清的球蛋白组分与异硫氰酸荧光素结合。所得的结合物能强烈地染色所有40株受试的艰难梭菌。它也能染色索氏梭菌、双发酵梭菌、产气荚膜梭菌和生孢梭菌的菌株，但不能染色其他20株梭菌分离株或10株来自其他菌种的分离株。用直接荧光抗体法检测粪便涂片的结果与检测粪便中艰难梭菌毒素以及在选择性培养基上培养艰难梭菌的结果进行了比较。共检测了158份来自抗生素相关性腹泻患者的粪便标本。在这些患者中，荧光抗体试验与培养及毒素检测结果在93%的标本中相符。然而，在正常成年人中，62%培养不出艰难梭菌的粪便标本经荧光抗体试验呈阳性。用索氏梭菌吸收结合物导致对其他梭菌以及20株艰难梭菌分离株中的18株失去反应性。
