caa a22 4500 477070051 CHVBK 20180405111422.0 cr unu---uuuuu 170330e19960701xx s 000 0 eng 10.1007/BF01709364 doi (NATIONALLICENCE)springer-10.1007/BF01709364 Comparison of four laboratory tests for diagnosis of Clostridium difficile -associated diarrhea [Elektronische Daten] [J. Jacobs, B. Rudensky, J. Dresner, A. Berman, M. Sonnenblick, Y. van Dijk, A. Yinnon] Four different laboratory tests for diagnosis ofClostridium difficile-associated diarrhea were compared to determine the optimal one for management of patients with hospital-acquired diarrhea. Stool samples from 231 patients with diarrhea were tested by the following methods: culture forClostridium difficile with subsequent determination of exotoxin production, with a toxigenicClostridium difficile positive (TCP) result considered truly positive; enzyme immunoassay (EIA); latex agglutination test; and an immunobinding blot assay. The rates of positive results were as follows: EIA 5.5%, TCP 7.3%, latex agglutination 16.7%, and immunobinding blot assay 26.1%. Compared to the TCP results, the sensitivity and specificity were, respectively, 61 and 98% for EIA, 47 and 85% for latex agglutination, and 60 and 76% for the immunobinding blot assay. Samples from patients with ≥ 6 stools/day were TCP and EIA positive in 27 and 17% of cases, respectively, whereas in patients with < 6 stools/day, these percentages decreased to 2 and 3%, respectively (p < 0.001). In hospitalized patients with ≥ 6 stools/day, EIA appears to be the optimal test for diagnosis ofClostridium difficile-associated diarrhea, with a 73% positive predictive value and a 97% negative predictive value. However, in patients with < 6 stools/day, the prevalence ofClostridium difficile is low, and laboratory detection of this organism remains problematic. MMV Medizin Verlag GmbH, 1996 Jacobs J. Department of Geriatrics, Shaare Zedek Medical Center, PO Box 3235, 91031, Jerusalem, Israel aut Rudensky B. Clinical Microbiological Laboratory, Shaare Zedek Medical Center, PO Box 3235, 91031, Jerusalem, Israel aut Dresner J. Department of Medicine, Shaare Zedek Medical Center, PO Box 3235, 91031, Jerusalem, Israel aut Berman A. Clinical Microbiological Laboratory, Shaare Zedek Medical Center, PO Box 3235, 91031, Jerusalem, Israel aut Sonnenblick M. Department of Geriatrics, Shaare Zedek Medical Center, PO Box 3235, 91031, Jerusalem, Israel aut van Dijk Y. Department of Geriatrics, Shaare Zedek Medical Center, PO Box 3235, 91031, Jerusalem, Israel aut Yinnon A. Infectious Diseases Unit, Shaare Zedek Medical Center, PO Box 3235, 91031, Jerusalem, Israel aut European Journal of Clinical Microbiology and Infectious Diseases Springer-Verlag 15/7(1996-07-01), 561-566 0934-9723 15:7<561 1996 15 10096 https://doi.org/10.1007/BF01709364 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/BF01709364 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Jacobs J. Department of Geriatrics, Shaare Zedek Medical Center, PO Box 3235, 91031, Jerusalem, Israel aut NATIONALLICENCE 700 1- Rudensky B. Clinical Microbiological Laboratory, Shaare Zedek Medical Center, PO Box 3235, 91031, Jerusalem, Israel aut NATIONALLICENCE 700 1- Dresner J. Department of Medicine, Shaare Zedek Medical Center, PO Box 3235, 91031, Jerusalem, Israel aut NATIONALLICENCE 700 1- Berman A. Clinical Microbiological Laboratory, Shaare Zedek Medical Center, PO Box 3235, 91031, Jerusalem, Israel aut NATIONALLICENCE 700 1- Sonnenblick M. Department of Geriatrics, Shaare Zedek Medical Center, PO Box 3235, 91031, Jerusalem, Israel aut NATIONALLICENCE 700 1- van Dijk Y. Department of Geriatrics, Shaare Zedek Medical Center, PO Box 3235, 91031, Jerusalem, Israel aut NATIONALLICENCE 700 1- Yinnon A. Infectious Diseases Unit, Shaare Zedek Medical Center, PO Box 3235, 91031, Jerusalem, Israel aut NATIONALLICENCE 773 0- European Journal of Clinical Microbiology and Infectious Diseases Springer-Verlag 15/7(1996-07-01), 561-566 0934-9723 15:7<561 1996 15 10096 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer