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KMID : 1100820210110020124
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Laboratory Medicine Online
2021 Volume.11 No. 2 p.124 ~ p.131
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Correlation Between Fecal Toxin Enzyme Immunoassays and Disease Severity in Patients with Clostridioides difficile Infection in a Korean University Hospital
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Han Eun-Hee
Lee Seung-Ok
Jekarl Dong-Wook
Ji Jeong-Seon
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Abstract
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Background: The aim of this study was to evaluate the clinical usefulness of the Clostridioides difficile toxin enzyme immunoassay (EIA) and nucleic acid amplification test (NAAT) in determining the severity of C. difficile infection (CDI) according to three different severity criteria: the ATLAS score of Miller et al., the CDAD severity score of Zar FA et al., and the CDSS score of Na et al.
Methods: From December 2015 to May 2018, 91 patients suspected of suffering from antibiotic-related diarrhea among those who tested positive (including equivocal) in either fecal C. difficile toxin EIA (VIDAS toxin A/B enzyme-linked fluorescent assay, BioMerieux SA, France) or NAAT (Seeplex Diarrhea ACE kit, Seegene, Korea), or both were tested to investigate the correlation between the results of each assay and the severity of CDI via retrospective medical record review and statistical testing.
Results: For the 88 C. difficile tcdB NAAT positive cases, EIA positivity significantly correlated with the ATLAS score (P=0.005) but did not correlate with the CDAD severity (P=0.107) and CDSS scores (P=0.534). When EIA equivocal results were considered to be positive results, EIA positivity correlated with the CDAD severity (P=0.03) and ATLAS scores (P<0.001) but did not correlate with the CDSS score (P=0.169).
Conclusions: The C. difficile toxin EIA assay may be clinically useful in assessing the severity of disease in CDI patients, especially in correlation with ATLAS severity scores.
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KEYWORD
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Clostridioides difficile infection, Toxin enzyme immunoassay, Disease severity
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