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A Protocol to Characterize the Morphological Changes of Clostridium difficile in Response to Antibiotic Treatment
Published on: May 25, 2017
Laboratory Experience with the Liaison Analyzer in the Diagnosis of Clostridium Difficile-Associated Diarrhea
Orsolya Benedek1, Andreas Podbielski1, Philipp Warnke1
1Institute of Medical Microbiology, Virology and Hygiene, University Hospital Rostock , Rostock, Germany.
Insights
The glutamate dehydrogenase chemiluminescent immunoassay (GDH-CLIA) shows high sensitivity for diagnosing Clostridium difficile infections. However, technical issues with the LIAISON analyzer impacted workflow efficiency.
Area of Science:
- Clinical diagnostics
- Microbiology
- Immunochemistry
Background:
- Clostridium difficile-associated diarrhea diagnosis commonly utilizes immunoassays.
- Chemiluminescent and enzyme-linked fluorescent immunoassays are prevalent methods.
Purpose of the Study:
- To compare the diagnostic performance of the LIAISON analyzer against miniVIDAS and culture for Clostridium difficile.
- To assess the performance of these diagnostic platforms under routine laboratory conditions.
Main Methods:
- Analysis of 249 native stool samples.
- Comparison of LIAISON and miniVIDAS analyzers against toxigenic strain culture.
- Evaluation of sensitivity, specificity, and predictive values.
Main Results:
- The glutamate dehydrogenase chemiluminescent immunoassay (GDH-CLIA) demonstrated high sensitivity and negative predictive value.
- Toxins A&B assays showed low sensitivity but high specificity.
- The LIAISON analyzer experienced technical issues in 48% of analyses, delaying results and disrupting workflow.
Conclusions:
- The analytical performance of diagnostic platforms must be considered within the context of laboratory workflow.
- Technical reliability is crucial for efficient Clostridium difficile diagnostics.
Background:
Chemiluminescent or enzyme-linked fluorescent immunoassays are commonly used to diagnose Clostridium difficile-associated diarrhea.
Methods:
The LIAISON analyzer (DiaSorin, Italy) was compared to miniVIDAS (bioMérieux, France) and, furthermore, to culture of toxigenic strains. In total, 249 native stool samples were analyzed. Sensitivities, specificities, and positive and negative predictive values were investigated. Furthermore, performance under routine conditions was assessed.
Results:
The glutamate dehydrogenase chemiluminescent immunoassay (GDH-CLIA) assay revealed a high sensitivity and negative predictive value. The toxins A&B assays exhibited approximately the same low sensitivity and high specificity. Technical drawbacks experienced with the LIAISON analyzer in 48% of the analyses considerably delayed the time to the first diagnostic report and interfered with laboratory routine workflow.
Conclusion:
The analytical performance of the investigated platforms should be reflected in the context of implementation into the laboratory workflow.
