Evaluation of glutamate dehydrogenase (GDH) and toxin A/B rapid tests for Clostridioides (prev. Clostridium ) difficile
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CLINICAL MICROBIOLOGY - SHORT COMMUNICATION
Evaluation of glutamate dehydrogenase (GDH) and toxin A/B rapid tests for Clostridioides (prev. Clostridium) difficile diagnosis in a university hospital in Minas Gerais, Brazil Carolina Pantuzza Ramos 1 & Emily Oliveira Lopes 1 & Amanda Nádia Diniz 1 Eduardo Garcia Vilela 2,3 & Rodrigo Otávio Silveira Silva 1
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Francisco Carlos Faria Lobato 1
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Received: 24 March 2020 / Accepted: 25 April 2020 # Sociedade Brasileira de Microbiologia 2020
Abstract 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. Keywords Pseudomembranous colitis . Nosocomial diarrhea
Clostridioides (Clostridium) difficile is responsible for most cases of antibiotic-associated diarrhea worldwide [1]. Despite the severity of the disease, the best laboratory diagnostic approach to diagnose C. difficile infection (CDI) is a subject of ongoing debate [2]. The diagnosis of CDI is frequently based on the clinical history and the detection of A/B toxins, and/or Responsible Editor: Roxane Piazza. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s42770-020-00288-z) contains supplementary material, which is available to authorized users. * Rodrigo Otávio Silveira Silva [email protected] 1
Veterinary School, Federal University of Minas Gerais, Antônio Carlos Avenue, 6627, Belo Horizonte, MG 31.270-901, Brazil
2
Faculty of Medicine, Federal University of Minas Gerais, Prof. Alfredo Balena Avenue, 190, Belo Horizonte, MG 30.130-100, Brazil
3
Alfa Institute of Gastroenterology, Clinical Hospital of Federal University of Minas Gerais, Prof. Alfredo Balena Avenue, 110, Belo Horizonte, MG 30.130-100, Brazil
toxigenic isolates, by a combination of laborious methods [3]. In this context, the use of rapid tests for the detection of C. difficile glutamate dehydrogenase (GDH) is increasing as a screening method due to its low cost, high sensitivity, and fast results [4, 5]. However, if thi
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