Ann Lab Med.  2019 Mar;39(2):214-217. 10.3343/alm.2019.39.2.214.

Simultaneous Detection of Clostridioides difficile Glutamate Dehydrogenase and Toxin A/B: Comparison of the C. DIFF QUIK CHEK COMPLETE and RIDASCREEN Assays

• Yoo IY
• Song DJ
• Huh HJ
• Lee NY

• KMID: 2425979
• DOI: http://doi.org/10.3343/alm.2019.39.2.214

Abstract

Various commercial assays have recently been developed for detecting glutamate dehydrogenase (GDH) and/or toxin A/B to diagnose Clostridioides difficile infection (CDI). We compared the performance of two assays for the simultaneous detection of C. difficile GDH and toxin A/B, using 150 stool samples: C. DIFF QUIK CHEK COMPLETE (QCC; TechLab, Blacksburg, VA, USA) and RIDASCREEN Clostridium difficile GDH (RC-GDH) and Toxin A/B (RC-Toxin A/B; R-Biopharm, Darmstadt, Germany). For GDH detection, QCC and RC-GDH showed satisfactory sensitivity (95.7% and 94.3%, respectively) and specificity (92.5% and 93.8%, respectively) compared with C. difficile culture. For toxin A/B detection, QCC showed higher sensitivity than RC-Toxin A/B (60.0% vs 33.3%, P < 0.001) compared with toxigenic C. difficile culture. When the results of QCC or RC-GDH+RC-Toxin A/B were used as the first step of a two-step algorithm for diagnosing CDI, QCC permitted more accurate discrimination than RC of positive or negative results for CDI (77.3% and 65.3%, respectively). QCC is useful for the simultaneous detection of C. difficile GDH and toxin A/B as a part of the two-step algorithm for diagnosing CDI.

Keyword

Clostridioides difficile; Glutamate dehydrogenase; Toxin A/B; Performance; Algorithm

MeSH Terms

Clostridium difficile
Discrimination (Psychology)
Glutamate Dehydrogenase*
Glutamic Acid*
Sensitivity and Specificity
Glutamate Dehydrogenase
Glutamic Acid

Figure

• 

  Fig. 1 Two-step algorithm for diagnosis of toxigenic Clostridioides difficile infection by applying QCC or RC-GDH and Toxin A/B.Abbreviations: QCC, C. DIFF QUIK CHEK COMPLETE, QUIK-CHEK COMPLETE; RC, RIDASCREEN Clostridium difficile; FP, false positive; FN, false negative; CDI, Clostridioides difficile infection; GDH, glutamate dehydrogenase; NAAT, nucleic acid amplification test; TC, toxigenic Clostridioides difficile culture.

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