Effective detection of toxigenic Clostridium difficile by a two-step algorithm including tests for antigen and cytotoxin

John R. Ticehurst; Deborah Z. Aird; Lisa M. Dam; Anita P. Borek; John T. Hargrove; Karen C. Carroll

doi:10.1128/JCM.44.3.1145-1149.2006

Effective detection of toxigenic Clostridium difficile by a two-step algorithm including tests for antigen and cytotoxin

John R. Ticehurst, Deborah Z. Aird, Lisa M. Dam, Anita P. Borek, John T. Hargrove, Karen C. Carroll

Research output: Contribution to journal › Article › peer-review

168 Scopus citations

Abstract

We evaluated a two-step algorithm for detecting toxigenic Clostridium difficile: an enzyme immunoassay for glutamate dehydrogenase antigen (Ag-EIA) and then, for antigen-positive specimens, a concurrent cell culture cytotoxicity neutralization assay (CCNA). Antigen-negative results were ≥99% predictive of CCNA negativity. Because the Ag-EIA reduced cell culture workload by ≈75 to 80% and two-step testing was complete in ≤3 days, we decided that this algorithm would be effective. Over 6 months, our laboratories' expenses were US$143,000 less than if CCNA alone had been performed on all 5,887 specimens.

Original language	English (US)
Pages (from-to)	1145-1149
Number of pages	5
Journal	Journal of clinical microbiology
Volume	44
Issue number	3
DOIs	https://doi.org/10.1128/JCM.44.3.1145-1149.2006
State	Published - Mar 2006

ASJC Scopus subject areas

Microbiology (medical)

Access to Document

10.1128/JCM.44.3.1145-1149.2006

Cite this

@article{db8c8d21b4704e859170df88e482d7b2,

title = "Effective detection of toxigenic Clostridium difficile by a two-step algorithm including tests for antigen and cytotoxin",

abstract = "We evaluated a two-step algorithm for detecting toxigenic Clostridium difficile: an enzyme immunoassay for glutamate dehydrogenase antigen (Ag-EIA) and then, for antigen-positive specimens, a concurrent cell culture cytotoxicity neutralization assay (CCNA). Antigen-negative results were ≥99% predictive of CCNA negativity. Because the Ag-EIA reduced cell culture workload by ≈75 to 80% and two-step testing was complete in ≤3 days, we decided that this algorithm would be effective. Over 6 months, our laboratories' expenses were US$143,000 less than if CCNA alone had been performed on all 5,887 specimens.",

author = "Ticehurst, {John R.} and Aird, {Deborah Z.} and Dam, {Lisa M.} and Borek, {Anita P.} and Hargrove, {John T.} and Carroll, {Karen C.}",

year = "2006",

month = mar,

doi = "10.1128/JCM.44.3.1145-1149.2006",

language = "English (US)",

volume = "44",

pages = "1145--1149",

journal = "Journal of Clinical Microbiology",

issn = "0095-1137",

publisher = "American Society for Microbiology",

number = "3",

}

TY - JOUR

T1 - Effective detection of toxigenic Clostridium difficile by a two-step algorithm including tests for antigen and cytotoxin

AU - Ticehurst, John R.

AU - Aird, Deborah Z.

AU - Dam, Lisa M.

AU - Borek, Anita P.

AU - Hargrove, John T.

AU - Carroll, Karen C.

PY - 2006/3

Y1 - 2006/3

N2 - We evaluated a two-step algorithm for detecting toxigenic Clostridium difficile: an enzyme immunoassay for glutamate dehydrogenase antigen (Ag-EIA) and then, for antigen-positive specimens, a concurrent cell culture cytotoxicity neutralization assay (CCNA). Antigen-negative results were ≥99% predictive of CCNA negativity. Because the Ag-EIA reduced cell culture workload by ≈75 to 80% and two-step testing was complete in ≤3 days, we decided that this algorithm would be effective. Over 6 months, our laboratories' expenses were US$143,000 less than if CCNA alone had been performed on all 5,887 specimens.

AB - We evaluated a two-step algorithm for detecting toxigenic Clostridium difficile: an enzyme immunoassay for glutamate dehydrogenase antigen (Ag-EIA) and then, for antigen-positive specimens, a concurrent cell culture cytotoxicity neutralization assay (CCNA). Antigen-negative results were ≥99% predictive of CCNA negativity. Because the Ag-EIA reduced cell culture workload by ≈75 to 80% and two-step testing was complete in ≤3 days, we decided that this algorithm would be effective. Over 6 months, our laboratories' expenses were US$143,000 less than if CCNA alone had been performed on all 5,887 specimens.

UR - http://www.scopus.com/inward/record.url?scp=33644902113&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33644902113&partnerID=8YFLogxK

U2 - 10.1128/JCM.44.3.1145-1149.2006

DO - 10.1128/JCM.44.3.1145-1149.2006

M3 - Article

C2 - 16517916

AN - SCOPUS:33644902113

VL - 44

SP - 1145

EP - 1149

JO - Journal of Clinical Microbiology

JF - Journal of Clinical Microbiology

SN - 0095-1137

IS - 3

ER -

Effective detection of toxigenic Clostridium difficile by a two-step algorithm including tests for antigen and cytotoxin

Abstract

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this