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Evaluation of the Xpert Clostridium difficile assay for the diagnosis of Clostridium difficile infection

 Saeam Shin  ;  Minkyung Kim  ;  Myungsook Kim  ;  Heejung Lim  ;  Heejung Kim  ;  Kyungwon Lee  ;  Yunsop Chong 
 ANNALS OF LABORATORY MEDICINE, Vol.32(5) : 355-358, 2012 
Journal Title
Issue Date
Clostridium Infections/diagnosis* ; Clostridium Infections/epidemiology ; Clostridium Infections/microbiology ; Clostridium difficile/genetics ; Clostridium difficile/isolation & purification* ; Clostridium difficile/metabolism ; Face/microbiology ; Humans ; Multiplex Polymerase Chain Reaction ; Prevalence ; Reagent Kits, Diagnostic/standards* ; Sensitivity and Specificity
Clostridium difficile ; Enzyme immunoassay ; Real-time PCR
Infection with Clostridium difficile is a growing concern because of the increasing prevalence and spread of nosocomial infections. Emergence of the hypervirulent 027/NAP1/BI strain is also notable. Existing diagnostic methods have low sensitivity or are time-consuming. Therefore, establishing a rapid and accurate microbiological diagnostic assay is needed. We evaluated the Xpert C. difficile assay (Xpert CD assay; Cepheid, USA) to detect toxigenic C. difficile. This assay is a real-time multiplex PCR assay that can be used to detect toxigenic C. difficile strains and differentiate the C. difficile presumptive 027/NAP1/BI strain. A total of 253 loose stool specimens were collected and toxigenic cultures, VIDAS C. difficile A & B assays (VIDAS CDAB assay; bioMérieux, France), and the Xpert CD assay were performed. In comparison to toxigenic cultures, the sensitivity, specificity, and positive and negative predictive values were 100%, 94.6%, 83.1%, and 100%, respectively, for the Xpert CD assay and 40.8%, 98.0%, 100%, and 88.9%, respectively, for VIDAS CDAB assay. Because of the low prevalence of the PCR ribotype 027 in Korea, the evaluation of the usefulness of the Xpert CD assay for screening for the 027 strain was limited. The Xpert CD assay provides great sensitivity in diagnosing toxigenic C. difficile infection. In addition, this method has excellent usability because it is simple and fast. KEYWORDS: Clostridium difficile, Enzyme immunoassay, Real-time PCR
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1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Heejung(김희정) ORCID logo https://orcid.org/0000-0002-0190-703X
Lee, Kyungwon(이경원) ORCID logo https://orcid.org/0000-0003-3788-2134
Chong, Yun Sop(정윤섭)
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