2008
DOI: 10.1128/jcm.00931-08
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Evaluation of Repeat Clostridium difficile Enzyme Immunoassay Testing

Abstract: Clostridium difficile is the leading cause of antibiotic-associated diarrhea and pseudomembranous colitis, which have significant morbidity and mortality. Accurate and timely diagnosis is critical. Repeat enzyme immunoassay testing for C. difficile toxin has been recommended because of <100% sensitivity. All C. difficile tests between 1 January 2006 and 31 December 2006 were retrospectively analyzed for results and testing patterns. The Wampole C. difficile Tox A/B II enzyme immunoassay kit was used. There wer… Show more

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Cited by 47 publications
(33 citation statements)
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“…All repeat GDH-Q specimens submitted within one to three days of the first test were negative, whereas 8% of those specimens submitted after four to six days were found to be toxin positive. This is similar to the results of Cardona and Rand, who recommended against repeating AB-Q testing within 48 h of a negative result (16).…”
Section: Discussionsupporting
confidence: 90%
See 1 more Smart Citation
“…All repeat GDH-Q specimens submitted within one to three days of the first test were negative, whereas 8% of those specimens submitted after four to six days were found to be toxin positive. This is similar to the results of Cardona and Rand, who recommended against repeating AB-Q testing within 48 h of a negative result (16).…”
Section: Discussionsupporting
confidence: 90%
“…Submission of repeat specimens from patients with an initial GDH-Q-negative specimen and no history of a previous positive toxin result produced positive toxin results in 3.0% of specimens tested within 7 days of the negative initial test, comparable to previous reports of 1.3 to 2.1% (1,16,40). All repeat GDH-Q specimens submitted within one to three days of the first test were negative, whereas 8% of those specimens submitted after four to six days were found to be toxin positive.…”
Section: Discussionsupporting
confidence: 83%
“…haps more importantly, a significant number of active C. difficile carriers are undiagnosed, leading to unmitigated transmission in health care settings. Often one or more stool specimens are collected following the first EIA-negative result if the suspicion of CDI is high (10,20). Algorithms for C. difficile testing in the hospital setting have evolved due to the need for more-accurate assays to better detect those patients with CDI (26,31).…”
Section: Discussionmentioning
confidence: 99%
“…More recently, real-time PCR assays targeting the tcdB toxin B gene of C. difficile have been developed and made commercially available as an alternative to EIA or cell culture cytotoxicity testing of stool (2,7,9,13,17,18,19). Due to the historically low sensitivity of EIAs, a common practice has been to order multiple EIAs to increase the test's sensitivity, despite recent studies suggesting that this may not be helpful and could result in increased false positives (5,11,12). Similarly, given the higher sensitivity of PCR testing and the role of toxin B as the essential virulence factor of C. difficile, multiple PCR tests may not be necessary (10,15).…”
mentioning
confidence: 99%