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Detection of Clostridium difficile toxins in stools. Comparison between a new enzyme immunoassay for toxin A and other routine tests.

C. Depitre, V. Avesani, Michel Delmée, Gérard Corthier

Abstract

An enzyme-linked immunosorbent assay (ELISA) for detection of Clostridium difficile toxin A (enterotoxin) using a monoclonal antibody is described. No cross-reaction was observed with any of the Clostridium species tested except for toxigenic Clostridium difficile. One hundred and eight stool specimens from hospitalized patients harbouring C. difficile in their intestine and 43 samples negative for C. difficile isolation were studied to compare this test with a cytotoxicity assay, the isolation of toxigenic C. difficile and the commercial EIA Premier test (Meridian). As compared with the cytotoxicity assay and EIA, specificity was 91 and 100%, while sensitivity 83 and 74% respectively. This ELISA technique could be used as a routine test for toxin A detection in stools.

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Key concepts: Clostridium difficile, Toxin, Enterotoxin, Immunoassay, Clostridiaceae, Microbiology, Clostridium difficile toxin A, Medicine