14th ICID - Poster Abstracts - International Society for Infectious ...

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When citing these abstracts please use the following reference: Author(s) of abstract. Title of abstract [abstract]. Int J Infect Dis 2010;14S1: Abstract number. Please note that the official publication of the International Journal of Infectious Diseases 2010, Volume 14, Supplement 1 is available electronically on http://www.sciencedirect.com Final Abstract Number: 75.006 Session: Diagnostics Date: Friday, March 12, 2010 Time: 12:30-13:30 Room: Poster & Exhibition Area/Ground Level Type: Poster Presentation Evaluation of PCR versus EIA for diagnosis of Clostridium difficile infection M. T. Busowski, C. DeRyke, D. bohmer, J. D. Busowski, R. Franklin, A. F. Walsh, M. R. Wallace Orlando Health, Orlando, FL, USA Background: Despite the rising morbidity and mortality of Clostridium difficile infection (CDI), a rapid and reliable test to confirm the diagnosis remains elusive. The cell culture cytotoxin assay (CCCA), considered the gold standard, is complex and time consuming. Commonly used EIA methods for detecting toxins A & B have sensitivities of only 50-90%, leading to confusion regarding the interpretation of negative tests. The Cepheid Xpert Clostridium difficile PCR test was recently FDA approved and may improve sensitivity and specificity with faster turnaround time. We sought to evaluate the clinical utility of this new PCR test compared to the standard Meridian Premier EIA toxin A/B test. Methods: Consecutive stool samples submitted for detection of C. difficile toxin at our 808 bed medical center were analyzed with both Meridian Premier EIA and Cepheid's Xpert PCR assay. The first submitted stool sample for each adult hospitalized patient was included. True CDI was defined as a positive test by either the PCR or EIA methods, along with the presence of clinical symptoms of infection (ie, diarrhea, fever, abdominal pain, elevated WBC count). If the test were discordant, CCCA was performed at a reference laboratory. Results: 161 cases met inclusion criteria; 30 cases (18.6%) were diagnosed with CDI. The sensitivity, specificity, positive & negative predictive values of the PCR test (97%, 100%, 100%, and 99%) were superior to the EIA test (43%, 97%, 76%, and 88%). Four cases were EIA+/PCR- ; only one of these had clinical symptoms consistent with CDI. EIA-/PCR+ was noted in 16 cases; all clinically had CDI. Of 16 discordant samples that underwent CCCA, only 1 (6%) tested positive. Conclusion: PCR significantly improved the diagnosis of patients with suspected CDI; 16 additional patients with clinically evident disease were detected by PCR that were missed by EIA. CCCA was insensitive, with no correlation to other testing methods or clinical disease. PCR testing appears superior to EIA and allows for rapid, reliable diagnosis and timely institution of therapy and initiation of infection control measures. The enhanced sensitivity of PCR may obviate the need for additional testing.
When citing these abstracts please use the following reference: Author(s) of abstract. Title of abstract [abstract]. Int J Infect Dis 2010;14S1: Abstract number. Please note that the official publication of the International Journal of Infectious Diseases 2010, Volume 14, Supplement 1 is available electronically on http://www.sciencedirect.com Final Abstract Number: 75.007 Session: Diagnostics Date: Friday, March 12, 2010 Time: 12:30-13:30 Room: Poster & Exhibition Area/Ground Level Type: Poster Presentation Serodiagnosis of tuberculosis using nine in silico predicted B-cell epitopes peptides derived from Mycobacterium tuberculosis proteins L. BAASSIi 1 , K. Sadki 2 , F. Seghrouchni 2 , S. Contini 3 , W. Cherki 2 , N. Nagelkerke 4 , A. Benjouad 5 , C. Saltini 3 , V. Colizzi 3 , R. El aouad 2 , M. Amicosante 3 1 National Institute of Hygiene- Ministry of Health, Rabat, Morocco, 2 National Institute of Hygiene, Rabat, Morocco, 3 University of Rome “Tor Vergata”, Rome, Italy, 4 United Arab Emirates University, Al Ain, United Arab Emirates, 5 Université Mohamed V, Rabat, Morocco Background: Rapid, simple, and new diagnostic tools are needed for the diagnosis of tuberculosis (TB). The aim of this study is to identify a combination of Mycobacterium tuberculosis (Mtb) peptides useful for the serodiagnosis of active pulmonary tuberculosis (TBp). Methods: Fifty-seven B-cell epitopes peptides of Mtb were selected by in silico methods and evaluated by immunoenzymatic assay. Two sample panels were used for evaluation: (i) twenty pulmonary tuberculosis (TBp) patients and ten healthy subjects (HS) from a country with low incidence of TB (Italy) and (ii) forty-seven TBp patients and 26 HS from a country with high incidence of TB (Morocco) and the data were analyzed using logistic regression analysis and Random Forest method. Results: The best discriminating peptide between TBp patients and HS from the sample of the country with low incidence of TB has been the 23 amino acid peptide of the Rv3878 protein. Thus, the sensitivity and specificity was 65 % and 100 %, respectively. In contrast, the same peptide showed 47% and 100% as sensitivity and specificity respectively in the country with high incidence of TB. In addition, the best peptides combination was a pool of nine peptides which showed a sensitivity of 70.2% and a specificity of 100% in the country with high incidence of TB. Conclusion: The present study showed that the 9-peptides pool can be useful in identifying patients with active pulmonary tuberculosis.
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