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KMID : 0384119930130030461
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Korean Journal of Clinical Pathology
1993 Volume.13 No. 3 p.461 ~ p.466
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Toxin Test and Quantitative Culture of Stool for the Diagnosis of Clostridium difficile Associated Diseases
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Abstract
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Toxin test is known to be most accurate for the diagnosis of Clostridium difficile associated diseases. However, due to technical difficulties, quantitative stool culture and latex agglutination test are more often used in clinical laboratories.
The
reliability of a test depends on the prevalence of a disease. In this study, accuracy of toxin test by cell culture and quantitative bacterial culture were compared using stool specimens taken from patients with clinically suspected C. difficile
diseases. Toxin test was considered to be positive when stool filtrates showed cytopathic effect at a titer of 1:40 and above, and their toxic effect was neutralized with antitoxin. The minimum number of the bacteria detected in this study was
102CFU/g.
Among the 64 specimens, only 15(23%) were toxin positive. Of the 57 specimens, 40(70%) were both test negative and 12(21%) were both positive. Three(20%) of the 15 culture-positive specimens were toxin negative while 2(14%) of 14 toxin positive
specimens were culture negative. It is concluded that even the quantitative stool culture may give significant number of false positve results.
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