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A rapid test for infectious and inflammatory enteritis

J R Miller1, L J Barrett, K Kotloff

  • 1Department of Medicine, University of Virginia School of Medicine, Charlottesville.

Archives of Internal Medicine
|December 12, 1994
PubMed
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A new fecal lactoferrin latex bead agglutination (LFLA) test accurately detects inflammatory diarrhea, even with stored samples. This rapid assay aids in diagnosing infectious diarrheal illnesses.

Area of Science:

  • Gastroenterology
  • Infectious Diseases
  • Clinical Diagnostics

Background:

  • Fecal leukocytes are markers for inflammatory diarrhea, but traditional microscopic examination is unreliable with processed specimens.
  • Current diagnostic methods for infectious diarrhea lack sensitivity and speed, especially for preserved samples.

Purpose of the Study:

  • To evaluate the rapid, sensitive, and semiquantitative antilactoferrin latex bead agglutination (LFLA) assay for detecting fecal leukocytes.
  • To determine if LFLA remains sensitive with refrigerated, frozen, or swab-collected stool specimens.

Main Methods:

  • LFLA titers were measured in stool samples from healthy volunteers experimentally infected with enteric pathogens.
  • LFLA titers were also analyzed in patients with nosocomial diarrhea caused by Clostridium difficile.

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Main Results:

  • Non-inflammatory diarrhea (e.g., Vibrio cholerae) showed low LFLA titers (<1:50).
  • Inflammatory diarrhea (Shigella, C. difficile, enteropathogenic E. coli) demonstrated significantly elevated LFLA titers (≥1:400 in 43-78% of cases).
  • Enterotoxigenic E. coli infection showed moderately elevated titers, indicating milder inflammation.

Conclusions:

  • The fecal LFLA assay effectively differentiates inflammatory from non-inflammatory diarrhea.
  • LFLA provides valuable insights into mildly inflammatory diarrheal processes.
  • This rapid test can be a useful tool in the diagnostic workup of acute infectious diarrhea.