ArticleJournal of clinical microbiology2013
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.
Article in Journal of clinical microbiology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 1 of them a synthesis that pooled it.
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Who cites it
34 citing papers in PubMed, 1 synthesis or guideline pooled it, 71 citations in OpenAlex.
- Systematic Review on the Correlation of Quantitative PCR Cycle Threshold Values of Gastrointestinal Pathogens With Patient Clinical Presentation and Outcomes.Frontiers in medicine · 2021Pooled it
- A Clinical Trial to Evaluate the Efficacy of α-Viniferin inPolish journal of microbiology · 2021Trial
- Lab-in-a-Tube System Integrating Hierarchically Wrinkled Electrodes and DNAzyme-Functionalized Beads for Diagnosis of Clostridioides difficile Infection.Advanced materials (Deerfield Beach, Fla.) · 2026Article
- Evaluation of the STANDARD M10 and XpertMicrobiology spectrum · 2026Article
- A novel RNA nucleic acid amplification test more accurately distinguishes activemedRxiv : the preprint server for health sciences · 2026Article
- Article
- Use of PCR cycle threshold values for toxins A and B quantification in Clostridioides difficile infections.Scientific reports · 2025Article
- Diagnostic Guidance for C. difficile Infections.Advances in experimental medicine and biology · 2024Article
- Novel Biomarkers, IncludingInfection and immunity · 2023Article
- Article
- Clinical Significance of Toxigenic Clostridioides difficile Growth in Stool Cultures during the Era of Nonculture Methods for the Diagnosis of C. difficile Infection.Microbiology spectrum · 2021Article
- Performance of commercial PCR assays to detect toxigenic Clostridioides difficile in the feces of puppies.Veterinary medicine and science · 2021Article
- A 2-step algorithm combining glutamate dehydrogenase and nucleic acid amplification tests for the detection of Clostridioides difficile in stool specimens.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2021Article
- Prospective Evaluation of the mariPOC Test for Detection of Clostridioides difficile Glutamate Dehydrogenase and Toxins A/B.Journal of clinical microbiology · 2020Article
- Ultrasensitive Detection of Clostridioides difficile Toxins in Stool by Use of Single-Molecule Counting Technology: Comparison with Detection of Free Toxin by Cell Culture Cytotoxicity Neutralization Assay.Journal of clinical microbiology · 2019Article
- Dual Reporting of Clostridioides difficile PCR and Predicted Toxin Result Based on PCR Cycle Threshold Reduces Treatment of Toxin-Negative Patients without Increases in Adverse Outcomes.Journal of clinical microbiology · 2019Observational
- Guidelines Support the Value of Stand-Alone Nucleic Acid Amplification Tests forJournal of clinical microbiology · 2019Article
- Ultrasensitive Detection of Clostridium difficile Toxins Reveals Suboptimal Accuracy of Toxin Gene Cycle Thresholds for Toxin Predictions.Journal of clinical microbiology · 2019Article
- Article
- Toxin B PCR Amplification Cycle Threshold Adds Little to Clinical Variables for Predicting Outcomes inJournal of clinical microbiology · 2019Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
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.
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