COMPARISON OF THE TOXA TEST WITH CYTOTOXICITY ASSAY AND CULTURE FOR THE DETECTION OF CLOSTRIDIUM-DIFFICILE-ASSOCIATED DIARRHEAL DISEASE

Stool samples (355 from 350 patients) were examined in a new commercia l assay, the ToxA test, for the rapid diagnosis of Clostridium diffici le-associated diarrhoea. The results were compared with direct assay o f cytotoxin in McCoy cell tissue culture, and detection of toxigenic C . difficile by culture and cytotoxin testing of isolates. Discordant r esults were resolved by consultation of clinical records. Test sensiti vities were 84.6 % for the ToxA test, 78.5 % for the direct cytotoxici ty assay and 95.4 % for culture. The specificity was 100 % for all the tests. The ToxA test is a rapid and reliable alternative for the dete ction of toxigenic C. difficile where tissue culture facilities are un available.