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[Comparison of rapid tests of toxin A and glutamate dehydrogenase and culture for detection of Clostridium diffcile].

Clostridium difficile is a major cause of antibiotics-associated diarrhea (AAD), and accounts for 15-20% of all the cases. Especially, AAD caused by C. difficile is called as C. difficile-associated diarrhea (CDAD). Diagnosis of CDAD is made by identification of C. difficile in the feces obtained from the patients with diarrhea after administration of antibiotics. We herein compared 3 methods, detection of toxin A and glutamate dehydrogenase (GDH) as well as culture for C. difficile. Two hundred and thirty-two samples obtained from 148 patients with CDAD were investigated. Fifty-five (23.7%), 56 (24.1%), and 93 (40.1%) of the 232 samples were positive for toxin A, GDH, and culture, respectively. Sensitivity, specificity, predictive value of positive result, and predictive value of negative result of method of detection of toxin A were estimated to 53%, 96%, 90%, 75% and those of GDH were 56%, 99%, 98%, 78%. These results indicated that we should carefully interpret the results obtained by these methods, especially in the cases that showed negative for C. difficile.