Use of gas-liquid chromatography as a screening test for toxigenic Clostridium difficile in diarrhoeal stools.

Pepersack, F.; Labbé, Martine; Nonhoff, Claire; Schoutens, E

doi:10.1136/jcp.36.11.1233

Cited by 26 publications

(11 citation statements)

References 13 publications

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“…Fatty acids were extracted from a stool sample (lg) and analysed by GLC for the presence of isocaproie acid according to the method of Pepersack et al (14). Chromatographic analysis was performed at 140 °12 on a Hewlett-Packard 5880 A chromatograph equipped with a 6 foot AT 1200 + H3PO4 packed glass column (Allteeh) and a flame ionization detector.…”

Section: Methodsmentioning

confidence: 99%

Incidence and significance ofclostridium difficile in hospitalized cancer patients

Gerard

Defresne

Daneau

et al. 1988

Eur. J. Clin. Microbiol. Infect. Dis.

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The aim of the study was to assess the incidence and clinical significance of Clostridium difficile in patients in our cancer center. Over a period of seven consecutive months, 557 stools samples obtained from 156 hospitalized cancer patients (37 leukemic patients receiving oral antimicrobial prophylaxis and 119 patients from whom a stool sample was sent to the laboratory) were analyzed for the presence of Clostridium difficile. Clostridium difficile and/or its toxin was recovered from 13 (35%) of the 37 patients receiving oral antimicrobial prophylaxis, and from 15 (12%) of the other 119 patients (p less than 0.05). Isolation of Clostridium difficile was associated with diarrhoea in 13 (46%) of 28 patients but specific treatment was initiated only in 7 (25%) of the 28 patients in whom Clostridium difficile was isolated. The wide distribution of the serotypes identified in our patients does not suggest an epidemic situation in our hospital.

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Section: Methodsmentioning

confidence: 99%

Incidence and significance ofclostridium difficile in hospitalized cancer patients

Gerard

Defresne

Daneau

et al. 1988

Eur. J. Clin. Microbiol. Infect. Dis.

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“…In addition, the concentrations of cycloserine and cefoxitin and the type of basal medium affect the recovery rate and the phenotypic properties (e.g., the intensity of the fluorescence) exhibited by the organism (130,131). Some of the unusual metabolic products (e.g., p-cresol and isocaproic acid) produced by C. difficile have been suggested as markers for the organism (54, 84,129,134,150,171,175,182). The detection of these substances is not specific enough to be used as a marker for clinical diagnosis.…”

Section: Isolation and Identification Of The Organismmentioning

confidence: 99%

Clostridium difficile: its disease and toxins

1988

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Clostridium difficile is the etiologic agent of pseudomembranous colitis, a severe, sometimes fatal disease that occurs in adults undergoing antimicrobial therapy. The disease, ironically, has been most effectively treated with antibiotics, although some of the newer methods of treatment such as the replacement of the bowel flora may prove more beneficial for patients who continue to relapse with pseudomembranous colitis. The organism produces two potent exotoxins designated toxin A and toxin B. Toxin A is an enterotoxin believed to be responsible for the diarrhea and mucosal tissue damage which occur during the disease. Toxin B is an extremely potent cytotoxin, but its role in the disease has not been as well studied. There appears to be a cascade of events which result in the expression of the activity of these toxins, and these events, ranging from the recognition of a trisaccharide receptor by toxin A to the synergistic action of the toxins and their possible dissemination in the body, are discussed in this review. The advantages and disadvantages of the various assays, including tissue culture assay, enzyme immunoassay, and latex agglutination, currently used in the clinical diagnosis of the disease also are discussed.

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“…By extracting faecal suspensions with ether, Potvliege et al (60) were able to presumptively identify Clostridium difficile in 61% of specimens that contained either Clostridium difficile or cytotoxin by conventional methods. In a similar study, Pepersack et al (61) confirmed this finding and suggested that direct gas liquid chromatography examination of faecal samples was an excellent screening test for excluding Clostridium difficile infection. Shortly after, Levett (62) examined the correlation between the isolation of Clostridium difficile from stools and the presence of isocaproic and isovaleric acids, and p-cresol.…”

Section: Fluorescent Antibody Techniques Have Been Widely Employed Tomentioning

confidence: 69%

Laboratory diagnosis ofClostridium difficile-associated diarrhoea

Bowman

Riley

1988

Eur. J. Clin. Microbiol. Infect. Dis.

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This paper reviews the various laboratory procedures available for the isolation and identification of Clostridium difficile and the detection of toxins produced by this organism. Laboratories should be selective in determining which patients require investigation for Clostridium difficile-associated diarrhoea. Transport and storage of stool specimens at 4 degrees C is recommended when delays in processing may occur. Tissue culture techniques are still the best method for detection of cytotoxin and a variety of cell lines can be used. Other methods for detecting cytotoxin, and methods for detecting other toxins are not sufficiently developed yet to warrant introduction into diagnostic laboratories. Culture techniques remain the most sensitive for diagnosis, particularly since the development of a variety of enrichment techniques. Cycloserine cefoxitin fructose agar is still adequate, although reduced concentrations of antimicrobial agents are necessary, and improvements, such as the addition of sodium taurocholate, increase the recovery of spores. Enrichment cultures have markedly increased isolation rates for Clostridium difficile but the significance of these isolates needs to be carefully evaluated. Until simpler and more reliable tests are available in clinical laboratories for the detection of toxins, the isolation of Clostridium difficile from patients with diarrhoeal disease should be considered paramount.

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Use of gas-liquid chromatography as a screening test for toxigenic Clostridium difficile in diarrhoeal stools.

Cited by 26 publications

References 13 publications

Incidence and significance ofclostridium difficile in hospitalized cancer patients

Incidence and significance ofclostridium difficile in hospitalized cancer patients

Clostridium difficile: its disease and toxins

Laboratory diagnosis ofClostridium difficile-associated diarrhoea

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