Evaluation of glutamate dehydrogenase (GDH) and toxin A/B rapid tests for Clostridioides (prev. Clostridium) difficile diagnosis in a university hospital in Minas Gerais, Brazil

• Published in: Brazilian journal of microbiology Vol. 51; no. 3; pp. 1139 - 1143
• Main Authors: Ramos, Carolina Pantuzza, Lopes, Emily Oliveira, Diniz, Amanda Nádia, Lobato, Francisco Carlos Faria, Vilela, Eduardo Garcia, Silva, Rodrigo Otávio Silveira
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.09.2020; Springer Nature B.V
• Subjects: Algorithms; Bacterial Proteins - analysis; Bacterial Proteins - metabolism; Bacterial Toxins - analysis; Bacterial Toxins - metabolism; Biomedical and Life Sciences; Brazil; Clinical Microbiology - Short Communication; Clostridioides; Clostridioides difficile - chemistry; Clostridioides difficile - enzymology; Clostridioides difficile - metabolism; Clostridium; Clostridium Infections - diagnosis; Clostridium Infections - microbiology; Dehydrogenase; Dehydrogenases; Diagnosis; Diagnostic systems; Diagnostic Tests, Routine - methods; Diarrhea; Enzyme immunoassay; Enzyme-linked immunosorbent assay; Enzyme-Linked Immunosorbent Assay - methods; Food Microbiology; Glutamate dehydrogenase; Glutamate Dehydrogenase - analysis; Glutamate Dehydrogenase - metabolism; Hospitals; Hospitals, University; Humans; Immunoassay; Immunoassay - methods; Life Sciences; Medical Microbiology; Microbial Ecology; Microbial Genetics and Genomics; Microbiology; Mycology; Nosocomial infection; Sensitivity; Toxin A; Toxins; Brazil; Nosocomial diarrhea; Pseudomembranous colitis
• ISSN: 1517-8382; 1678-4405; 1678-4405
• DOI: 10.1007/s42770-020-00288-z

Clostridioides ( Clostridium ) difficile is responsible for most cases of nosocomial diarrhea and, despite the high prevalence of the disease worldwide, the best laboratory diagnostic approach to diagnose C. difficile infection (CDI) is a subject of ongoing debate. Although the use of multiple tests is recommended, the cost of these algorithms commonly exceeds the affordability in some countries. Thus, to improve CDI diagnosis in a university hospital in Brazil, this study analyzed two immunochromatographic tests and one enzyme immunoassay (ELISA) to evaluate the detection of glutamate dehydrogenase (GDH) and A/B toxins of C. difficile . Stool samples of 89 adult patients presenting nosocomial diarrhea during hospitalization were included. The toxigenic culture was used as the reference method. GDH detection by both commercial tests showed high sensitivity (100%) and specificity (92.1%). On the other hand, toxin-based methods showed a sensitivity between 19.2 and 57.7%. In conclusion, the results suggest that rapid tests for GDH detection are not only suitable for CDI diagnosis as screening tests but also as a single method.