ArticleJournal of clinical microbiology2010
Impact of strain type on detection of toxigenic Clostridium difficile: comparison of molecular diagnostic and enzyme immunoassay approaches.
Article in Journal of clinical microbiology, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 79 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
79 citing papers in PubMed, 6 syntheses or guidelines pooled it, 204 citations in OpenAlex.
- Clinical significance of toxin EIA positivity in patients with suspectedJournal of clinical microbiology · 2025Pooled it
- Evaluation of the Cepheid Xpert C. difficile diagnostic assay: an update meta-analysis.Brazilian journal of microbiology : [publication of the Brazilian Society for Microbiology] · 2021Pooled it
- Pooled it
- Clinical Practice Guidelines for Clostridium difficile Infection in Adults and Children: 2017 Update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA).Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2018Guideline
- Accuracy of Xpert Clostridium difficile assay for the diagnosis of Clostridium difficile infection: A meta analysis.PloS one · 2017Pooled it
- Molecular techniques for diagnosis of Clostridium difficile infection: systematic review and meta-analysis.Mayo Clinic proceedings · 2012Pooled it
- Clostridioides difficile pathogenesis and control.Nature reviews. Microbiology · 2026Review
- Incidence of hospital-acquired toxin-producing clostridioides difficile infection between the pre-pandemic (2017-2019) and pandemic (2020-2022): a retrospective cohort study.Archives of public health = Archives belges de sante publique · 2026Article
- Diagnosis ofJournal of medical microbiology · 2024Review
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- Article
- Biographical Feature: Fred C. Tenover, Ph.D., D(ABMM), F(AAM), FIDSA.Journal of clinical microbiology · 2021Article
- Impact of ribotype on Clostridioides difficile diagnostics.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2020Article
- Trends in U.S. Burden ofThe New England journal of medicine · 2020Article
- Laboratory Tests for the Diagnosis ofClinics in colon and rectal surgery · 2020Review
- A Multicenter Study of the Revogene C. difficile System for Detection of the Toxin B Gene from Unformed Stool Specimens.Journal of clinical microbiology · 2020Article
- Rapid and fully-automated detection ofAmerican journal of translational research · 2020Article
- Two-Dimensional Layered Nanomaterial-Based Electrochemical Biosensors for Detecting Microbial Toxins.Toxins · 2019Review
- Toxin Enzyme Immunoassays Detect Clostridioides difficile Infection With Greater Severity and Higher Recurrence Rates.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2019Article
- Clostridioides difficile Infection in the Stem Cell Transplant and Hematologic Malignancy Population.Infectious disease clinics of North America · 2019Review
19 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
18 authors at 12 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
A multicenter clinical trial assessed the performance of the Cepheid Xpert C. difficile assay on stool specimens collected from patients suspected of having Clostridium difficile infection (CDI). A total of 2,296 unformed stool specimens, collected from seven study sites, were tested by Xpert C. difficile enrichment culture followed by cell culture cytotoxicity testing of the isolates (i.e., toxigenic culture with enrichment) and the study sites' standard C. difficile test methods. The methods included enzyme immunoassay (EIA), direct cytotoxin testing, and two- and three-step algorithms using glutamate dehydrogenase (GDH) screening followed by either EIA or EIA and an in-house PCR assay. All C. difficile strains were typed by PCR-ribotyping. Compared to results for toxigenic culture with enrichment, the sensitivity, specificity, and positive and negative predictive values of the Xpert assay were 93.5, 94.0, 73.0, and 98.8%, respectively. The overall sensitivity of the EIAs compared to that of enrichment culture was 60.0%, and the sensitivity of combined GDH algorithms was 72.9%; both were significantly lower than that of Xpert C. difficile (P < 0.001 and P = 0.03, respectively). The sensitivity of the EIA was significantly lower than that of the Xpert C. difficile assay for detection of ribotypes 002, 027, and 106 (P < 0.0001, P < 0.0001, and P = 0.004, respectively, Fisher's exact test), and the sensitivity of GDH algorithms for ribotypes other than 027 was lower than that for Xpert C. difficile (P < 0.001). The Xpert C. difficile assay is a simple, rapid, and accurate method for detection of toxigenic C. difficile in unformed stool specimens and is minimally affected by strain type compared to EIA and GDH-based methods.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.