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首页> 外文期刊>Journal of Clinical Microbiology >Correlation between Clostridium difficile Bacterial Load, Commercial Real-Time PCR Cycle Thresholds, and Results of Diagnostic Tests Based on Enzyme Immunoassay and Cell Culture Cytotoxicity Assay
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Correlation between Clostridium difficile Bacterial Load, Commercial Real-Time PCR Cycle Thresholds, and Results of Diagnostic Tests Based on Enzyme Immunoassay and Cell Culture Cytotoxicity Assay

机译：基于酶免疫测定和细胞培养细胞毒性测定的梭菌艰难梭菌细菌载荷，商业实时PCR循环阈值和诊断试验结果的相关性

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The impact of Clostridium difficile fecal loads on diagnostic test results is poorly understood, but it may have clinical importance. In this study, we investigated the relationship between C. difficile fecal load and the results of four assays: a glutamate dehydrogenase (GDH) enzyme immunoassay (EIA), a toxin A/B antigen EIA (ToxAB), a cell culture cytotoxicity assay (CCA), and PCR targeting the tcdB gene. We also compared the PCR cycle threshold (CT) with the results of quantitative culture using Spearman's rank correlation coefficient. Finally, we sequenced the genomes of 24 strains with different detection profiles. A total of 203 clinical samples harboring toxigenic C. difficile were analyzed and sorted into one of four groups: 17 PCR+ (group 1), 37 PCR+ GDH+ (group 2), 24 PCR+ GDH+ CCA+ (group 3), and 125 PCR+ GDH+ ToxAB+ (group 4). The overall median fecal load in log10 CFU/g was 6.67 (interquartile range [IQR], 5.57 to 7.54). The median fecal bacterial load of groups 1, 2, 3, and 4 were 4.15 (IQR, 3.00 to 4.98), 5.74 (IQR, 4.75 to 6.16), 6.20 (IQR, 5.23 to 6.80), and 7.08 (IQR, 6.35 to 7.83), respectively. Group 1 samples had lower fecal loads than those from each of the other groups (P < 0.001). Group 2 samples had lower fecal loads than those from groups 3 and 4 (P < 0.001). There was a significant correlation between PCR CT and fecal loads (ρ = ?0.697; P < 0.001). NAP1 strains were associated with the detection of toxins by EIA or CCA (P = 0.041). This study demonstrates an association between C. difficile fecal load and the results of routinely used diagnostic tests.
机译：梭状芽孢杆菌的影响艰难的诊断测试结果粪便负荷知之甚少，但它可能具有重要的临床意义。在这项研究中，我们调查了C之间艰难粪便负载和4个检测结果的关系：（GDH）酶免疫测定（EIA），毒素A / B抗原EIA（ToxAB），细胞培养物细胞毒性测定谷氨酸脱氢酶（ CCA），和PCR靶向毒素tcdB 基因。我们还比较了PCR循环阈值（ C <子>Ť 的）与定量培养的使用斯皮尔曼等级相关系数的结果。最后，我们测序的24株不同的检测曲线的基因组。总共203个临床样品窝藏产毒艰难梭菌进行了分析和分类成四组中的一种：17的PCR + （第1组），37 PCR + GDH + （第2组），24 PCR + GDH + CCA + （组3），和125 PCR + GDH + ToxAB + （组4）。在日志<子>总的中位粪便负载10 CFU / g为6.67（四分位数间距[IQR]，5.57至7.54）。组1，2，3的中间粪便细菌负荷，和4分别为4.15（IQR，3.00至4.98），5.74（IQR，4.75至6.16），6.20（IQR，5.23至6.80），和7.08（IQR，6.35至7.83），分别。组1周的样品比那些来自各其它基团的低粪便负载（ P <0.001）。组2组的样品具有比来自组3和4的低级粪便负载（ P <0.001）。有PCR的 C <子>之间的显著相关性t- 的和粪便负载（ρ= 0.697; P <0.001）。 NAP1菌株与检测的通过EIA或CCA毒素相关联的（ P = 0.041）。这项研究表明，C之间艰难粪便负荷和常规使用的诊断测试的结果的关联。

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