Molecular test to determine toxigenic capabilities in GDH-positive, toxin-negative samples: evaluation of the Portrait toxigenic C. difficile assay.

This study aims to assess the introduction of the Portrait C. difficile assay as the third step to identify the presence of the toxigenic C. difficile B (tcdB) gene and thus determine toxigenic capability. Stool samples with a GDH-positive, toxin-negative result were tested using the Portrait analyser to detect the presence of tcdB. A retrospective evaluation was performed, assessing the clinical course of patients who were isolated as a result of the current algorithm using GDH enzyme immunoassay (EIA) and toxin EIA. Of the stool samples tested, 40% carried the tcdB gene. Four tcdB-positive stool samples initially toxin A/B-negative subsequently became positive. Thirteen patients were isolated, four of which did not have the tcdB gene. The total time to 'process' a positive CDI case was 102 hours and cost pounds 592. The additional time and cost of incorporating the Portrait toxigenic C. difficile assay was 105-115 minutes and pounds 46.48 to pounds 51.88. This study confirms that toxigenic capabilities in GDH-positive, toxin-negative specimens can facilitate effective treatment and infection prevention, and results show there is potential value in repeat toxin testing. PMID: 23888607 [PubMed - indexed for MEDLINE]
Source: British Journal of Biomedical Science - Category: Laboratory Medicine Tags: Br J Biomed Sci Source Type: research

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Source: American Journal of Infection Control - Category: Infectious Diseases Source Type: research
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Source: Journal of Microbiological Methods - Category: Microbiology Source Type: research
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Source: Antimicrobial Resistance and Infection Control - Category: Infectious Diseases Source Type: research
Abstract Clostridium difficile (CD) is a common pathogen that causes severe gastrointestinal inflammatory diarrhea in patients undergoing antibiotic therapy. Its virulence derives from two toxins, toxin CD, A &B (TcdA and TcdB) (10). Among the prime candidates for CD colonization are patients with cystic fibrosis (CF), who are routinely treated with antibiotics and frequently hospitalized. Indeed, ~50% of CF patients are colonized with virulent forms of CD but do not exhibit diarrhea (7, 9, 61). We found that TcdB has global effects on colonic cells, including reducing the steady-state levels of sodium proton ...
Source: Am J Physiol Gastroi... - Category: Gastroenterology Authors: Tags: Am J Physiol Gastrointest Liver Physiol Source Type: research
Abstract High-throughput small molecule screening in drug discovery processes commonly rely on fluorescence-based methods including fluorescent polarization and fluorescence/Förster resonance energy transfer. These techniques use highly accessible instrumentation, however may suffer from high false negative rates and background signals or, may involve complex schemes for the introduction of fluorophore pairs. Herein, we present the synthesis and application of fluorescent nucleoside analogues as the foundation for directed approaches for competitive binding analyses. The general approach describes s...
Source: Chembiochem - Category: Biochemistry Authors: Tags: Chembiochem Source Type: research
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Source: Vaccine - Category: Allergy & Immunology Authors: Tags: Vaccine Source Type: research
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Source: European Journal of Gastroenterology and Hepatology - Category: Gastroenterology Tags: Letters to the Editor Source Type: research
Source: International Journal of Infectious Diseases - Category: Infectious Diseases Authors: Source Type: research
In Reply We appreciate the comments rendered by Kanemoto et al and Ng et al in response to our study reporting surgical trends in the management of Clostridium difficile colitis. We used the National Inpatient Sample, the largest all-payor administrative database available in the United States, to derive the study cohort.
Source: JAMA Surgery - Category: Sports Medicine Source Type: research
To the Editor Juo et al found that no significant difference was observed between loop ileostomy (LI) and total abdominal colectomy (TAC) for treating fulminant Clostridium difficile colitis (FCDC) in their retrospective cohort study. The overall in-hospital mortality rate for patients undergoing surgery for FCDC was 30.1%, with no significant difference between LI and TAC (26.0% vs 31.1%; P  = .28). The findings would be beneficial for patients with FCDC because LI could be less invasive and maintain physiologic functions of colon compared with TAC. However, we are concerned about the higher rates of operati...
Source: JAMA Surgery - Category: Sports Medicine Source Type: research
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