Universität zu Köln

Jazmati, N., Kirpal, E., Piepenbrock, E., Stelzer, Y., Vehreschild, M. J. G. T. and Seifert, H. (2018). Evaluation of the Use of Rectal Swabs for Laboratory Diagnosis of Clostridium difficile Infection. J. Clin. Microbiol., 56 (7). WASHINGTON: AMER SOC MICROBIOLOGY. ISSN 1098-660X

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Abstract

For the diagnosis of Clostridium difficile infection (CDI), microbiological testing is almost always accomplished through the analysis of stool specimens. We evaluated the performances of rectal swabs with liquid transport medium (FS) and nylon flocked dry swabs for the detection of C. difficile. Additionally, the impact on the diagnostic yield of storing swabs at -80 degrees C for up to 3 months was evaluated. Sixty clinical stool samples positive for C. difficile by PCR were used for simulating rectal swabbing. FS and dry swabs were dipped into the stool and tested by PCR directly after swabbing at 1 and 3 months after storage at -80 degrees C. Stool and the liquid medium of FS were additionally tested by a combination of glutamate dehydrogenase antigen (GDH) testing and toxin A/B enzyme immunoassay (EIA), as well as by toxigenic culture (TC). Using dry swabs, the PCR-based detection rate of C. difficile was equal to the rate using stool samples (30/3. [100%]), whereas the detection rate in FS was significantly lower (25/30 [83.2%]; P = 0.019). The sensitivities of FS for detecting C. difficile by PCR, TC, GDH testing, and toxin A/B EIA were 83.3%, 85.7%, 88%, and 68.9%, respectively. Storage of swabs at -80 degrees C had no impact on the detection rate. FS cannot replace stool samples in the two-step laboratory diagnosis of CDI, as the sensitivities were too low, probably due to diluting effects of the fecal sample in the liquid medium. For simple PCR-based detection of C. difficile, dry swabs proved to be a suitable alternative to the use of stool samples.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Jazmati, N. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kirpal, E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Piepenbrock, E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Stelzer, Y. UNSPECIFIED UNSPECIFIED UNSPECIFIED Vehreschild, M. J. G. T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Seifert, H. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-180496
DOI:	10.1128/JCM.00426-18
Journal or Publication Title:	J. Clin. Microbiol.
Volume:	56
Number:	7
Date:	2018
Publisher:	AMER SOC MICROBIOLOGY
Place of Publication:	WASHINGTON
ISSN:	1098-660X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language TRANSPORT-SYSTEMS; FECALSWAB; CARRIERS; DELAYS Multiple languages Microbiology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/18049