A 2-step algorithm combining glutamate dehydrogenase and nucleic acid amplification tests for the detection of Clostridioides difficile in stool specimens
The optimized diagnosis algorithm of Clostridioides difficile infection (CDI) is worldwide concerns. The purpose of this study was to assess the toxigenic C. difficile test performance and propose an optimal laboratory workflow for the diagnosis of CDI in mild virulent epidemic areas. Diarrhea sampl...
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| Veröffentlicht in: | European journal of clinical microbiology & infectious diseases 2021-02, Vol.40 (2), p.345-351 |
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| creator | Liu, Chengcheng Tang, Chenjie Han, Yaping Xu, Yuqiao Ni, Fang Jin, Ke Liu, Genyan |
| description | The optimized diagnosis algorithm of
Clostridioides difficile
infection (CDI) is worldwide concerns. The purpose of this study was to assess the toxigenic
C. difficile
test performance and propose an optimal laboratory workflow for the diagnosis of CDI in mild virulent epidemic areas. Diarrhea samples collected from patients were analyzed by glutamate dehydrogenase (GDH), toxin AB (CDAB), and nucleic acid amplification test (NAAT). We assessed the performance of GDH, the GDH-CDAB algorithm, and the GDH-NAAT algorithm using toxigenic culture (TC) as a reference method. In this study, 186 diarrhea samples were collected. The numbers of TC-positive and TC-negative samples were 39 and 147, respectively. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and kappa of the GDH assay were 100%, 80.3%, 57.4%, 100%, and 0.63; of the GDH-CDAB algorithm were 48.7%, 97.3%, 82.6%, 87.7%, and 0.54; and of the GDH-NAAT algorithm were 74.4%, 100%, 100%, 93.6%, and 0.82, respectively. The GDH-NAAT algorithm has great concordance with TC in detecting toxigenic
C. difficile
(kappa = 0.82), while the sensitivity of the GDH-CDAB algorithm was too low to meet the demand of CDI diagnosis clinically. GDH-NAAT algorithm is recommended for the detection of toxigenic
C. difficile
with high specificity, increased sensitivity, and cost-effective. |
| doi_str_mv | 10.1007/s10096-020-04027-y |
| format | Article |
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Clostridioides difficile
infection (CDI) is worldwide concerns. The purpose of this study was to assess the toxigenic
C. difficile
test performance and propose an optimal laboratory workflow for the diagnosis of CDI in mild virulent epidemic areas. Diarrhea samples collected from patients were analyzed by glutamate dehydrogenase (GDH), toxin AB (CDAB), and nucleic acid amplification test (NAAT). We assessed the performance of GDH, the GDH-CDAB algorithm, and the GDH-NAAT algorithm using toxigenic culture (TC) as a reference method. In this study, 186 diarrhea samples were collected. The numbers of TC-positive and TC-negative samples were 39 and 147, respectively. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and kappa of the GDH assay were 100%, 80.3%, 57.4%, 100%, and 0.63; of the GDH-CDAB algorithm were 48.7%, 97.3%, 82.6%, 87.7%, and 0.54; and of the GDH-NAAT algorithm were 74.4%, 100%, 100%, 93.6%, and 0.82, respectively. The GDH-NAAT algorithm has great concordance with TC in detecting toxigenic
C. difficile
(kappa = 0.82), while the sensitivity of the GDH-CDAB algorithm was too low to meet the demand of CDI diagnosis clinically. GDH-NAAT algorithm is recommended for the detection of toxigenic
C. difficile
with high specificity, increased sensitivity, and cost-effective.</description><identifier>ISSN: 0934-9723</identifier><identifier>EISSN: 1435-4373</identifier><identifier>DOI: 10.1007/s10096-020-04027-y</identifier><identifier>PMID: 32944896</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Algorithms ; Amplification ; Biomedical and Life Sciences ; Biomedicine ; Clostridioides difficile ; Dehydrogenase ; Dehydrogenases ; Diagnosis ; Diarrhea ; Glutamate dehydrogenase ; Internal Medicine ; Medical Microbiology ; Nucleic acids ; Original Article ; Performance assessment ; Sensitivity ; Toxins ; Workflow</subject><ispartof>European journal of clinical microbiology & infectious diseases, 2021-02, Vol.40 (2), p.345-351</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2020</rights><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2020.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c290y-41b4c3d3ba50aee148de37a038e3b3f0fcda30e64e85e23e9ae0cb1570575d663</citedby><cites>FETCH-LOGICAL-c290y-41b4c3d3ba50aee148de37a038e3b3f0fcda30e64e85e23e9ae0cb1570575d663</cites><orcidid>0000-0002-1004-2517</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10096-020-04027-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10096-020-04027-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,778,782,27907,27908,41471,42540,51302</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32944896$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Liu, Chengcheng</creatorcontrib><creatorcontrib>Tang, Chenjie</creatorcontrib><creatorcontrib>Han, Yaping</creatorcontrib><creatorcontrib>Xu, Yuqiao</creatorcontrib><creatorcontrib>Ni, Fang</creatorcontrib><creatorcontrib>Jin, Ke</creatorcontrib><creatorcontrib>Liu, Genyan</creatorcontrib><title>A 2-step algorithm combining glutamate dehydrogenase and nucleic acid amplification tests for the detection of Clostridioides difficile in stool specimens</title><title>European journal of clinical microbiology & infectious diseases</title><addtitle>Eur J Clin Microbiol Infect Dis</addtitle><addtitle>Eur J Clin Microbiol Infect Dis</addtitle><description>The optimized diagnosis algorithm of
Clostridioides difficile
infection (CDI) is worldwide concerns. The purpose of this study was to assess the toxigenic
C. difficile
test performance and propose an optimal laboratory workflow for the diagnosis of CDI in mild virulent epidemic areas. Diarrhea samples collected from patients were analyzed by glutamate dehydrogenase (GDH), toxin AB (CDAB), and nucleic acid amplification test (NAAT). We assessed the performance of GDH, the GDH-CDAB algorithm, and the GDH-NAAT algorithm using toxigenic culture (TC) as a reference method. In this study, 186 diarrhea samples were collected. The numbers of TC-positive and TC-negative samples were 39 and 147, respectively. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and kappa of the GDH assay were 100%, 80.3%, 57.4%, 100%, and 0.63; of the GDH-CDAB algorithm were 48.7%, 97.3%, 82.6%, 87.7%, and 0.54; and of the GDH-NAAT algorithm were 74.4%, 100%, 100%, 93.6%, and 0.82, respectively. The GDH-NAAT algorithm has great concordance with TC in detecting toxigenic
C. difficile
(kappa = 0.82), while the sensitivity of the GDH-CDAB algorithm was too low to meet the demand of CDI diagnosis clinically. GDH-NAAT algorithm is recommended for the detection of toxigenic
C. difficile
with high specificity, increased sensitivity, and cost-effective.</description><subject>Algorithms</subject><subject>Amplification</subject><subject>Biomedical and Life Sciences</subject><subject>Biomedicine</subject><subject>Clostridioides difficile</subject><subject>Dehydrogenase</subject><subject>Dehydrogenases</subject><subject>Diagnosis</subject><subject>Diarrhea</subject><subject>Glutamate dehydrogenase</subject><subject>Internal Medicine</subject><subject>Medical Microbiology</subject><subject>Nucleic acids</subject><subject>Original Article</subject><subject>Performance assessment</subject><subject>Sensitivity</subject><subject>Toxins</subject><subject>Workflow</subject><issn>0934-9723</issn><issn>1435-4373</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9kcFu3CAURVGUKpmm-YEsIqSsaTFgYy-jUZNUitRNskYYnj1ENjiAF_6Vfm1JJm133YDEu-feJy5CVxX9WlEqv6Vydg2hjBIqKJNkO0G7SvCaCC75KdrRjgvSScbP0eeUXmiBWinP0DlnnRBt1-zQr1vMSMqwYD2NIbp8mLEJc--88yMepzXrWWfAFg6bjWEErxNg7S32q5nAGayNs1jPy-QGZ3R2weMMKSc8hIjz4Q3NYN7fw4D3U0g5OuuCs5CwdUOh3ATYeZxyCBNOCxg3g09f0KdBTwkuP-4L9Hz3_Wn_QB5_3v_Y3z4Swzq6EVH1wnDLe11TDVCJ1gKXmvIWeM8HOhirOYVGQFsD49BpoKavaklrWdum4Rfo5ui7xPC6ltXVS1ijL5GKCdkxVglZFxU7qkwMKUUY1BLdrOOmKqre6lDHOlSpQ73XobYCXX9Yr_0M9i_y5_-LgB8FqYz8CPFf9n9sfwNA6Jnz</recordid><startdate>20210201</startdate><enddate>20210201</enddate><creator>Liu, Chengcheng</creator><creator>Tang, Chenjie</creator><creator>Han, Yaping</creator><creator>Xu, Yuqiao</creator><creator>Ni, Fang</creator><creator>Jin, Ke</creator><creator>Liu, Genyan</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QL</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88A</scope><scope>88E</scope><scope>8AO</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><orcidid>https://orcid.org/0000-0002-1004-2517</orcidid></search><sort><creationdate>20210201</creationdate><title>A 2-step algorithm combining glutamate dehydrogenase and nucleic acid amplification tests for the detection of Clostridioides difficile in stool specimens</title><author>Liu, Chengcheng ; Tang, Chenjie ; Han, Yaping ; Xu, Yuqiao ; Ni, Fang ; Jin, Ke ; Liu, Genyan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c290y-41b4c3d3ba50aee148de37a038e3b3f0fcda30e64e85e23e9ae0cb1570575d663</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Algorithms</topic><topic>Amplification</topic><topic>Biomedical and Life Sciences</topic><topic>Biomedicine</topic><topic>Clostridioides difficile</topic><topic>Dehydrogenase</topic><topic>Dehydrogenases</topic><topic>Diagnosis</topic><topic>Diarrhea</topic><topic>Glutamate dehydrogenase</topic><topic>Internal Medicine</topic><topic>Medical Microbiology</topic><topic>Nucleic acids</topic><topic>Original Article</topic><topic>Performance assessment</topic><topic>Sensitivity</topic><topic>Toxins</topic><topic>Workflow</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Liu, Chengcheng</creatorcontrib><creatorcontrib>Tang, Chenjie</creatorcontrib><creatorcontrib>Han, Yaping</creatorcontrib><creatorcontrib>Xu, Yuqiao</creatorcontrib><creatorcontrib>Ni, Fang</creatorcontrib><creatorcontrib>Jin, Ke</creatorcontrib><creatorcontrib>Liu, Genyan</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Biology Database (Alumni Edition)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection (ProQuest)</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><jtitle>European journal of clinical microbiology & infectious diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Liu, Chengcheng</au><au>Tang, Chenjie</au><au>Han, Yaping</au><au>Xu, Yuqiao</au><au>Ni, Fang</au><au>Jin, Ke</au><au>Liu, Genyan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A 2-step algorithm combining glutamate dehydrogenase and nucleic acid amplification tests for the detection of Clostridioides difficile in stool specimens</atitle><jtitle>European journal of clinical microbiology & infectious diseases</jtitle><stitle>Eur J Clin Microbiol Infect Dis</stitle><addtitle>Eur J Clin Microbiol Infect Dis</addtitle><date>2021-02-01</date><risdate>2021</risdate><volume>40</volume><issue>2</issue><spage>345</spage><epage>351</epage><pages>345-351</pages><issn>0934-9723</issn><eissn>1435-4373</eissn><abstract>The optimized diagnosis algorithm of
Clostridioides difficile
infection (CDI) is worldwide concerns. The purpose of this study was to assess the toxigenic
C. difficile
test performance and propose an optimal laboratory workflow for the diagnosis of CDI in mild virulent epidemic areas. Diarrhea samples collected from patients were analyzed by glutamate dehydrogenase (GDH), toxin AB (CDAB), and nucleic acid amplification test (NAAT). We assessed the performance of GDH, the GDH-CDAB algorithm, and the GDH-NAAT algorithm using toxigenic culture (TC) as a reference method. In this study, 186 diarrhea samples were collected. The numbers of TC-positive and TC-negative samples were 39 and 147, respectively. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and kappa of the GDH assay were 100%, 80.3%, 57.4%, 100%, and 0.63; of the GDH-CDAB algorithm were 48.7%, 97.3%, 82.6%, 87.7%, and 0.54; and of the GDH-NAAT algorithm were 74.4%, 100%, 100%, 93.6%, and 0.82, respectively. The GDH-NAAT algorithm has great concordance with TC in detecting toxigenic
C. difficile
(kappa = 0.82), while the sensitivity of the GDH-CDAB algorithm was too low to meet the demand of CDI diagnosis clinically. GDH-NAAT algorithm is recommended for the detection of toxigenic
C. difficile
with high specificity, increased sensitivity, and cost-effective.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>32944896</pmid><doi>10.1007/s10096-020-04027-y</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-1004-2517</orcidid></addata></record> |
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| subjects | Algorithms Amplification Biomedical and Life Sciences Biomedicine Clostridioides difficile Dehydrogenase Dehydrogenases Diagnosis Diarrhea Glutamate dehydrogenase Internal Medicine Medical Microbiology Nucleic acids Original Article Performance assessment Sensitivity Toxins Workflow |
| title | A 2-step algorithm combining glutamate dehydrogenase and nucleic acid amplification tests for the detection of Clostridioides difficile in stool specimens |
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