RESUMEN
Objective: To assess a new immunochromatography (ICT) test that detects glutamate dehydrogenase (GDH) antigen and Clostridium difficile toxin A/B simultaneously, and to propose an algorithm for the diagnosis of C. difficile infection (CDI) based on this test. Methods We analysed 970 stool samples. Discrepant results between GDH and toxin A/B were resolved using toxigenic culture as the reference. Results This test enabled us to obtain a conclusive result in <30min in 93.8% of the samples. Among the discrepant results (GDH (+)/Toxin A/B (-)), 41.7% (25/60) were found to be toxigenic C. difficile by toxigenic culture. Conclusion This test has a high sensitivity and specificity for the diagnosis of CDI (AU)
Objetivo: Evaluar una nueva prueba inmunocromatográfica que detecta el antígeno glutamato deshidrogenasa (GDH) y la toxina A/B de Clostridium difficile simultáneamente y proponer un algoritmo para el diagnóstico de infección por C. difficile (ICD) basado en esta prueba. Métodos: Se analizaron 970 muestras. Las discrepancias entre GDH y toxina A/B se resolvieron utilizando el cultivo toxigénico como método de referencia. Resultados: Esta prueba permitió obtener el resultado del 93,8% de las muestras en < 30 minutos. El 41,7%(25/60) de las muestras discrepantes (GDH (+)/Toxina A/B (-)) fueron C. difficile toxigénicos, mediante cultivo toxigénico. Conclusión: Esta prueba es sensible y específica para el diagnóstico de ICD (AU)
Asunto(s)
Humanos , Clostridioides difficile/aislamiento & purificación , Infecciones por Clostridium/microbiología , Cromatografía de Afinidad/métodos , Sensibilidad y Especificidad , Infección Hospitalaria/diagnósticoRESUMEN
OBJECTIVE: To assess a new immunochromatography (ICT) test that detects glutamate dehydrogenase (GDH) antigen and Clostridium difficile toxin A/B simultaneously, and to propose an algorithm for the diagnosis of C. difficile infection (CDI) based on this test. METHODS: We analysed 970 stool samples. Discrepant results between GDH and toxin A/B were resolved using toxigenic culture as the reference. RESULTS: This test enabled us to obtain a conclusive result in <30min in 93.8% of the samples. Among the discrepant results (GDH (+)/Toxin A/B (-)), 41.7% (25/60) were found to be toxigenic C. difficile by toxigenic culture. CONCLUSION: This test has a high sensitivity and specificity for the diagnosis of CDI.
Asunto(s)
Algoritmos , Colorantes Azulados , Cromatografía de Afinidad , Infecciones por Clostridium/diagnóstico , Azul de Metileno , Xantenos , Antígenos Bacterianos/análisis , Cromatografía de Afinidad/instrumentación , Glutamato Deshidrogenasa/inmunología , HumanosRESUMEN
We conducted a retrospective study of 99 patients with methicillin-suseptible Staphylococcus aureus catheter-related bacteremia in which vancomycin MIC was determined by Etest. High vancomycin MIC (>1.5 ug/mL) was the only independent risk factor for development of complicated bacteremia caused by methicillin-susceptible S. aureus (odds ratio 22.9, 95% confidence interval 6.7-78.1).