CDI was defined as follows: (i) the presence of symptoms (diarrhea, fever, abdominal pain, or ileus) and a positive C. difficile enzyme immunoassay (ImmunoCard Toxins A&B, Meridian Bioscience, Inc.) or toxigenic culture, (ii) an endoscopic diagnosis of pseudomembranes, or (iii) a pathological/histological diagnosis of CDI. Diarrhea was defined as the passage of ≥3 new unformed stools within 24 h. Recurrent CDI was defined as a CDI diagnosis that occurs within 60 days after successfully completing the treatment for the initial episode of CDI. Asymptomatic C. difficile colonization was defined as a positive stool culture for C. difficile and the absence of a CDI diagnosis during follow-up. Colonization or infection was considered hospital-acquired if the diagnosis was made ≥48 h after hospital admission and during the study follow-up period.
Immunocard toxins a b
Manufactured by Meridian Bioscience
Sourced in United States
The ImmunoCard Toxins A&B is a rapid, qualitative immunoassay that detects the presence of Clostridium difficile toxins A and B in stool samples. The test provides results within 30 minutes, allowing for timely diagnosis of Clostridium difficile infection.
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Lab products found in correlation
3 protocols using immunocard toxins a b
1
Clostridium difficile Infection Criteria
2
Frequency of A-B-CDT+ C. difficile Strains
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To estimate the frequency of A−B−CDT+ strains, 220 consecutive nontoxinogenic strains (A−B−) isolated in Paris (North of France) (n = 84) and Montpellier (South of France) (n = 136) between July 2011 and April 2013 were screened. All strains were isolated from patients with diarrhoea who were suspected of having CDI, who were admitted in Saint Antoine (Paris) or Arnaud de Villeneuve (Montpellier) hospitals and strains were characterized as nontoxinogenic strains by toxigenic culture (TC). The in vitro determination of C. difficile isolates ability to produce toxins (TC) was performed either by inoculating supernatant from a 5-day brain–heart infusion broth (Oxoid) on MRC-5 cells (Paris) or by using ImmunoCard® Toxins A&B (Meridian Bioscience, Cincinnati, OH, USA) directly on colonies as recommended by the manufacturer (Montpellier).
Absence of the PaLoc was confirmed as described elsewhere by obtaining an amplification of about 700 bp using primers lok1 and lok3 anchored outside the targeting PaLoc [21] (link). In case of a negative result (i.e., absence of the PaLoc was not confirmed), amplification by PCR of tcdA, tcdB, tcdC, cdtA and cdtB genes, toxinotyping and PCR ribotyping were performed as described above [13] (link).
Absence of the PaLoc was confirmed as described elsewhere by obtaining an amplification of about 700 bp using primers lok1 and lok3 anchored outside the targeting PaLoc [21] (link). In case of a negative result (i.e., absence of the PaLoc was not confirmed), amplification by PCR of tcdA, tcdB, tcdC, cdtA and cdtB genes, toxinotyping and PCR ribotyping were performed as described above [13] (link).
3
Anaerobic Toxin Screening
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The stool samples collected were tested for toxins using the ImmunoCard toxins A&B assay (Meridian Bioscience, Cincinnati, OH, USA). Furthermore, fecal samples were collected from patients and were treated with ethanol shock for 3 h prior to inoculation on cycloserine-cefoxitin fructose agar (CCFA). Incubation was achieved in an anaerobic atmosphere using a GasPak EZ anaerobe pouch system (Becton Dickinson, Sparks, MA, USA) at 37°C for 48 h; and anaerobic colonies were identified using catalase, Gram staining, and the Crystal Identification System (Becton Dickinson).
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