Detection ofClostridium difficileas a Routine Diagnosis: Comparison of Real-Time PCR and Enzyme ImmunoassayThe Authors’ Reply

To the Editor: Molecular epidemiology of toxigenic Clostridium difficile isolates in Korea

“…Although the incidence of binary toxin in this study was slightly lower than in the previous report, we can reconfirm that isolates expressing binary toxin are not rare in Korea [2]. A partially deleted toxin A gene that could not be amplified using commercial real-time PCR was detected in six specimens (8·96%), which were all PCR ribotype 017 known to be prevalent in east Asia [4, 5]. We therefore suggest that any PCR ribotype 017 strain described as toxin A negative and B positive be examined carefully to confirm whether it really lacks the toxin A gene or has a partially deleted toxin A gene that is not detected with commercial kits, as shown here [4].…”

“…The remaining specimens were stored at -70°C until required for PCR ribotype analysis, as described previously [2]. Some of these 67 toxigenic strains were included in our previous studies [4]. Table 1 shows the PCR ribotype profiles of the 67 toxigenic C. difficile strains showing 10 different kinds of PCR ribotypes.…”

“…A partially deleted toxin A gene that could not be amplified using commercial real-time PCR was detected in six specimens (8·96%), which were all PCR ribotype 017 known to be prevalent in east Asia [4, 5]. We therefore suggest that any PCR ribotype 017 strain described as toxin A negative and B positive be examined carefully to confirm whether it really lacks the toxin A gene or has a partially deleted toxin A gene that is not detected with commercial kits, as shown here [4]. These accumulating clinical and laboratory data suggest that proper surveillance systems are needed to monitor and control this important infectious disease in Korea.…”

Consenso chileno de prevención, diagnóstico y tratamiento de la diarrea asociada a Clostridium difficile

“…81 , concluyó en una sensibilidad de 75-95% y una especificidad de 83-98%. Cuando se ha comparado el rendimiento de EIA con métodos de amplificación de ácidos nucleicos y test para detección de glutamato deshidrogenasa, la sensibilidad de estos últimos es consistentemente superior [80][81][82][83][84][85][86] . Cabe destacar que múltiples estudios han establecido que la ***** Recomendación basada en estudios diagnósticos que no comparan directamente este examen con exámenes de amplificación génica, pero con resultados consistentes (usando como estándar de oro el cultivo) y precisos.…”

Evaluation of a Chromogenic Culture Medium for the Detection ofClostridium difficile

“…The ability of chromID to detect toxigenic strains of C. difficile within 24-48 hours is a notable improvement from conventional anaerobic stool culture media. As use of anaerobic culture, in addition to confirmation of toxin production, improves the accuracy of diagnosis, the use of culture is encouraged 16,17…”